Impact of a GINA education and implementation programme: an interim analysis of a multi-centre, single-arm study (Care4All)

<bold>Background:</bold> The Care4All study (<ext-link>NCT05440097</ext-link>) is a national, multifaceted quality improvement programme (QIP) aiming to align asthma care in China with GINA recommendations. This interim analysis assessed its impact and potential risk factors for persistently poor asthma control at baseline and 12 weeks after implementation. <bold>Methods:</bold> Physicians received GINA education in the 12 weeks after recruitment and were required to apply the learnings to clinical practice and patient management. After 12 weeks, patients’ asthma control status (assessed by ACQ-5), health-related quality of life (QoL) (by AQLQ(S)+12) and medication use were compared with baseline. For patients with ACQ-5≥1.5 at baseline, differences were analysed between well/partially controlled (ACQ-5<1.5) group and not well controlled (ACQ-5≥1.5) group at 12-weeks. Multivariate logistic regression was performed to identify potential risk factors for persistently poor asthma control. <bold>Results:</bold> The FAS population (N=1,344) was used for analysis. At week 12, ICS-based medication use, patients with ACQ-5<1.5 and AQLQ(S)+12≥5 increased from baseline by 8.9% (40.3% of 1,344 to 49.2% of 1,236), 26.7% (51.4% of 1,340 to 78.1% of 1,149) and 22.5% (52.5% of 1,342 to 75.0% of 1,134), respectively. Older age (odds ratio [OR] 1.03; 95% confidence interval [CI] 1.01–1.05) and occupational exposure to irritants (OR 0.24; 95% CI 0.07–0.88) were associated with persistently poor asthma control. <bold>Conclusion:</bold> 12-week of asthma education for physicians notably improved standard medication use, asthma control and QoL. Occupational exposure and older age remain important risk factors for persistently poor asthma control in China.