How can we tackle SABA over-reliance in asthma management? Rationale and design of the Reliever Reliance Test (RRT) Impact Evaluation project in Argentina

Clinical Research Results Abstract Research Idea Abstract Research question: How can the impact of the Reliever Reliance Test (RRT) on patient behaviours be assessed in a real-world setting?Background: Following accumulating evidence that short-acting β2-agonist (SABA) overuse (≥3 canisters/year) is associated with poor asthma outcomes,1,2 the Global Initiative for Asthma now recommends inhaled corticosteroid–containing treatments as the mainstay of reliever treatment in asthma management.3 However, many patients continue to rely on SABAs because of entrenched beliefs, prescription habits and over-the-counter access to SABAs. The RRT4 (Table 1) comprises a 5-item SABA Reliance Questionnaire that categorises patients with asthma according to their risk of SABA over-reliance risk (low, medium or high) together with the provision of behaviourally intelligent messages addressing factors that impact medication use to positively influence patient behaviour and experience.Possible methodology: The first part of the evaluation pilot project will be a survey administered to patients immediately after their completion of the RRT to assess the effectiveness of the RRT in motivating them to highlight the issue of SABA over-reliance to their healthcare providers (HCPs) (intent; Figure 1). The second part will include a follow-up survey administered 6−8 weeks after completion of the RRT to identify whether the perceived need translates into behaviours, such as making or attending an HCP appointment (action; Figure 1). The survey will enrol 500 patients from January to April 2022, with 100 patients anticipated to complete both the intent and action questionnaires in Argentina.Questions to discuss: (1) How effectively will the RRT Impact Evaluation project help identify patients at risk of SABA over-reliance and address common misplaced beliefs about reliever use for asthma in Argentina?(2) Can future global implementation of this project positively impact patient behaviour?(3) What learnings can be taken from the pilot in Argentina to ensure a continuously successful global roll-out? Service Development & Evaluation Abstract Declaration of Interest This study is funded by AstraZeneca and supported by Spoonful of Sugar, a University College London (UCL) Business company. The associated RRT was developed by Prof. Rob Horne, UCL, with colleagues from the International Primary Care Respiratory Group (IPCRG), and fully funded by AstraZeneca UK Limited. References and Clinical Trial Registry Information 1. Nwaru B.I. et al. Eur Respir J 55:1901872 (2020). https://doi.org/10.1183/13993003.01872-2019 2. Bloom C.I. et al. Adv Ther 37:4190-4208 (2020). https://doi.org/10.1007/s12325-020-01444-5 3. Global Strategy for Asthma Management and Prevention. Global Initiative for Asthma (GINA) 2021. https://ginasthma.org/wp-content/uploads/2021/05/GINA-Main-Report-2021-V2-WMS.pdf 4. Reliever Reliance Test. Asthma Right Care and International Primary Care Respiratory Group. https://www.ipcrg.org/sites/ipcrg/files/content/attachments/2021-11-29/Reliever%20Reliance%20Test%20English.pdf