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Perceptions of healthcare professionals (HCPs) in primary care to stepping down treatment in people with asthma aged 12+ years Background 1. Please identify your role in primary care GP □ Nurse Practitioner □ PN □ Healthcare Assistant □ Other □, please specify.... Yes □ 2. Do you see people with asthma? Locum □ No □ If No, thank you very much for your time you do not need to complete the questionnaire. Review of people with asthma 3. How many people with asthma do you usually see in one month? 4. When did you last look at the BTS/SIGN guidelines for the management of asthma? 5. Do you adjust patients’ asthma medication? 11-20 □ 21-30 31-40 □ 41-50 □ >50 □ Last week □ Last year □ Last month □ Last 6 months □ 1-10 □ Yes □ 6. How confident do you feel about stepping down asthma medication? Do you have a practice or locality formulary for managing asthma? No □ If No, who in your team adjusts patients asthma medication? ..................... 1 Not very confident Yes □ 7. □ 2 3 4 5 Very confident No □ If Yes, does it list: Specific drugs Drugs by class Doses of drug Device choice Yes Yes Yes Yes □ □ □ □ No No No No □ □ □ □ Does this have guidance about stepping down treatment? Yes □ No □ 8. Thinking about people 12+ with asthma you have seen in previous 3 months, please indicate if you use the following to assess asthma control: RCP 3 questions Yes □ No □ Asthma Control Test (ACT) Yes □ No □ Checking Peak Expiratory Flow Rate (PEFR) Reliever usage (by asking patient and/or checking number of inhalers prescribed) Yes □ No □ Yes □ No □ 1|Page Napp Pharmaceuticals Ltd have supported this research through the production and formatting of the questionnaire. The content was produced by Deirdre Siddaway. RCP – have you had difficulty sleeping because of your asthma symptoms (including cough)? No symptoms for previous >3 months No symptoms for previous 1-3 months No symptoms for previous 1 month □ □ □ RCP –have you had your usual asthma symptoms during the day? 9. For the assessments you answered yes to in question 8, what level of symptoms would prompt you to step down treatment? No symptoms for previous >3 months No symptoms for previous 1-3 months No symptoms for previous 1 month □ □ □ RCP – Has your asthma interfered with your usual activities? No symptoms for previous >3 months No symptoms for previous 1-3 months No symptoms for previous 1 month □ □ □ 25 □ □ ACT: 20-24 □ <20 >90% □ >80% □ 70-80% PEFR (%best/predicted): Reliever usage in the last 3 months: None in last 3 months □ Used <3 in last 3 months □ 10. Once controlled, how long do you wait until you step down treatment? 11. When you step down asthma treatment would you reduce the dose of patients medication by: 3 months □ 6 months □ 1 year Changing to a lower dose of inhaled cortico-steroid inhaler Changing to a lower dose of long-acting beta2 agonist inhaler Reducing the number of puffs/actuations of current inhaler Other, please specify... □ □ Used <5 □ □ Would not follow-up □ >1 year □ Yes □ No □ Yes □ No □ Yes □ No □ 12. Thinking about patients whose treatment you have stepped down, please list any challenges you had stepping down treatment e.g. time 13. When would you arrange to follow-up with the patient after stepping down treatment? 14. What advice would you give about stepping up treatment if patients experience symptoms? 4-6 weeks □ 2 months □ 3 months Make an appointment to see HCP Increase the actuations taken Other, please specify.... Yes □ Yes □ No □ No □ Any other comments: Thank you very much for completing this questionnaire. Please return to: Deirdre Siddaway, The Chesterfield Drive Practice, 29 Chesterfield Drive, Ipswich, IP1 6DW or email to: [email protected] 2|Page Napp Pharmaceuticals Ltd have supported this research through the production and formatting of the questionnaire. The content was produced by Deirdre Siddaway.