Identification and tracking of patients with uncontrolled severe asthma in the Germans Trias i Pujol Hospital Health Area

<bold>Introduction:</bold> Patients with severe asthma should be managed in an Asthma Unit (AU) or by a pulmonologist in the area, especially if they've needed emergency care for exacerbation. The COVID-19 pandemic has likely disrupted their access to healthcare. We aimed to assess these patients' status post-COVID in our area to offer specialized care if needed. <bold>Materials and Methods:</bold> We conducted an observational, cross-sectional study. We identified asthma patients (ICD code J.45) on high-dose inhaled corticosteroids and a b2 adrenergic combination who had visited a primary care emergency center or hospital in 2021-2022. Out of 13,141 subjects, 85 met the criteria, had a telephone visit (V0), and completed ACT and TAI-10 questionnaires. Of these, 41 had a home visit (V1) for spirometry and FeNO. Subsequently, 18 of them (43.9%) had never been managed in the AU or lost follow-up. We compared demographics, treatment, ACT, TAI, lung function, and FeNO with 23 other patients (Figure 1). <bold>Results:</bold> Of 85 patients in V0, the ACT was 18 (5.2) with an ACT < 20 in 51.8%. The TAI was 46.3 (4.8) with poor/intermediate adherence in 60%. Comparing 41 V1 patients with 44 others showed no significant differences (Figure 2-Table 1). Comparing 18 unmanaged patients with 23 others showed a non-significant trend towards worse adherence and control. They also had significantly lower FeNO (Figure 2-Table 2). <bold>Conclusions:</bold> A significant number of severe asthmatics are not managed in the AU. They generally have poor adherence and control, especially those not managed in the AU. Measures are needed to access and improve care for these patients.