Background and Aims: Opportunities for standardising the clinical management of difficult-to-treat (DTT) and Severe Asthma (SA) need quantifying. The DTT asthma Quality Improvement (QI) program supports clinicians through identifying opportunities to enhance the recording of key standardised DTT and SA clinical data similar to those identified in the International Severe Asthma Registry (ISAR) Delphi exercise. To describe current recording of clinical variables relevant to the management of DTT and SA and opportunities for enhancing management in Australian secondary care.

Methods: Clinical data for DTT and SA patients were collected by reviewing de-identified Electronic Medical Records (EMR) and clinical letters during the DTT Asthma QI program. Anonymised data from the DTT Asthma QI program is included in the Optimum Patient Care Research Database Australia (OPCRDA), where patients with SA and/or DTT asthma were identified for inclusion. Descriptive analyses were conducted on a panel dataset based on number of visits.

Results: Of the 56 patients included, most patients had a recording of spirometry (91%), exacerbations (89.3%), and at least 1 biomarker (87.5%) (Table 1). All patients had recordings of Asthma management plans (100%). Of patients with recorded long-term OCS, daily dose was noted for 29% of patients. Adherence assessments were recorded for 26.8% of patients. Inhaler technique assessment was recorded for 33.9% of patients.

Conclusion: While the recording of key clinical data in DTT or SA is strong in Australian secondary care, it is predominantly recorded in clinical letters. This emphasises the opportunity for standardised clinical templates to support the capture of clinical data and enhance management.