1. Introduction Implementation of asthma guidelines at national level requires a collaborative approach between healthcare professionals. Health service providers and patient advocacy bodies to agree standards, test local barriers to implementation and identify the resources required to facilitate uptake in primary care. In Ireland 60% of adult asthma patients are uncontrolled 1 and recent data indicates that 96% of teenagers with current asthma have evidence of sub-optimal control 2, thus implementation of asthma guidelines is considered essential to reduce the impact of poor control on patients and the health service providers. The Asthma Society of Ireland funded and developed a comprehensive, multifaceted programme to investigate the feasibility of implementing evidence based-asthma guidelines in the primary care setting. Healthcare Professional Attitudes to Asthma Guidelines in Primary Care B. Elnazir 1, PJ Manning 2, E. Shannahan 3, M. Ní Chroinin 4, TM O’Connor 5, N. Williams, R. Forsythe 6, P. Logan 7, L. Coyne, F. Guiney, J. Holohan 8 1.Dept of Paediatrics, AMNCH, Dublin; 2.HSE Regional Hospital, Mullingar; 3.Farranfore Medical Centre, Kerry; 4. Dept of Paediatrics, Cork University Hospital, Cork; 5. Dept of Respiratory Medicine, Mercy University Hospital, Cork ; 6. Professional Development Co-ordinators for Practice Nurses HSE; 7. Irish Pharmacy Union, Dublin; 8. Asthma Society of Ireland, Dublin. Methods Aim The aim of the current study was to identify facilitators and barriers to the implementation of guideline-based treatment in health care professionals (HCP) in a primary care environment. We established the Asthma Demonstration Programme to evaluate these factors Methods We recruited a nationally representative sample of 25 primary care teams incorporating variables such as rural/urban mix and practice size Participants 25 primary care sites participated in programme. Prior to patients recruitment healthcare professionals were required to complete a guideline based asthma education programme and practical training to ensure understanding of the principles and core competencies in spirometry and patient education. Each primary care site received a comprehensive tool-kit including a spirometer and consumables, peak flow meters and asthma diaries, patient education materials, placebo inhalers and spacer devices, to provide the basic resources needed to optimise asthma care. A clinical governance group was established to guide the implementation of the project. This group included representation from respiratory physicians, primary care, nursing and community pharmacy. HCP completed a guideline-based education and training programme incorporating on- line modules and a practical session Patients (>5 years old) were recruited to follow guideline based care for a period of 6 months. Patient recruitment: 778 patients participated in the programme Patient data was captured on a specifically commissioned electronic patient record Baseline indicators of management not concordant with guidelines included: Uncontrolled / partly controlled asthma in 54% patients according to GINA criteria In the previous 12 months: 45% reported atleast one course of orla steroids 27% had been nebulised 37% had missed school / work 14% had an asthma related visit to ED 8% of patients had been hospitalised Only 6% of patients in this cohort had ever had a written asthma management plan 34% ever had education on inhaler technique Healthcare professionals were asked to evaluate the guideline, education and training, and the practical resources. Attitudes to Guideline Implementation were evaluated using a 5 point Likert Scale. The response rate was 89%. Ethical approval was obtained by the Research Ethics Committee of ICGP. Acknowledgements 1. The Asthma Society of Ireland fully funded the project 2. Participating Practices, their staff and enrolled patients 3. Clinical Governance Group (Author list) 4. Kevin O’Farrell, EPR Developer, Siteshare.ie Conclusion: Guideline-based care can be implemented successfully in primary care if practices are provided with the necessary resources for diagnosis, management and patient education There was strong endorsement of guideline-based care among health care professionals Health care professionals are committed to delivering high quality evidence based care for asthma patients The Irish Health Service Executive (HSE) has incorporated the locally modified guideline and associated asthma education programme into the core components of the new National Asthma Programme For further information contact : Dr. Jean Holohan, CEO, Asthma Society of Ireland, 26, Mountjoy Square, Dublin 1. Tel: +353 1 8788511. Email jean.holohan@asthmasociety.ie Web: www.asthmasociety.iejean.holohan@asthmasociety.ie References 1.I. Kelly, P. Fitzpatrick. Sub-optimal asthma control in teenagers in the midlands regions of Ireland. Ir J Med Sci DOI 10.1007/s11845-011-0725-1 2.J. Holohan. Attitudes to Implementation of GINA Asthma Guidelines Facilitated Programme at Primary Care Level in the Republic of Ireland [Abstract]. In: Irish Thoracic Society Annual Scientific Meeting, Cork 5-6 th November 2010 Results 46 Healthcare Professionals (HCP) participated in this study and 89% of HCP completed the survey. Comments from participants “Asthma can be managed successfully in primary care” “Up-graded the practice” “Peak flow meter on my desk all the time” “Enjoy dealing with asthma much more now – get more satisfaction from management”