Home administration of targeted asthma biologics is an option for patients with severe eosinophilic asthma, allowing greater independence in the management of their disease and more convenience around work, study and travel. Organisational gains include time and cost savings. In 2022 a directive was issued by the Health Service Executive of Ireland stating that from the third dose patients should be self-administering at home.

In our hospital the respiratory Clinical Nurse Specialists are responsible for the coordination of the asthma biologic service. In addition to assessing, managing and administering the drugs, as experienced asthma Clinical Nurse Specialists, we now needed to identify patients who could transition safely to self-administration. Developing an assessment tool allowed us to determine if patients met the criteria for self-administration of therapy by facilitating assessment of health literacy, executive function, commitment to treatment and adherence to baseline therapies. Using this tool allowed us to;

· Provide a consistent programme of education.

· Assess competency in self-administration.

· Document knowledge and skills acquired by the patient.

· Facilitate audit of outcomes of the training and education.

This tool supports ongoing monitoring and review of patients who have successfully transitioned to home administration to ensure continued adherence and allows early intervention for any deterioration in asthma control. Patients deemed unsuitable for self-administration continue to attend our weekly dedicated nurse-led asthma biologic therapy clinics.