Introduction: The goal of asthma management is to achieve optimal asthma control. Maintenance and reliever inhaler therapy (MART) is increasingly being recommended but is novel in Emergency Departments (ED), that tend to discharge patients with salbutamol inhalers. Understanding beliefs and experiences of switching medications could indicate feasibility and support needed for such inhaler changes in the ED.

Aims: This study aimed to explore the health beliefs and behaviours of patients and healthcare professionals (HCP) around switching to MART in the ED.

Methods: 38 semi-structured face-to-face or online interviews were conducted with patients and HCP in 2021/22. Eligible participants were patients over age 16 who had attended and been discharged from the ED with an asthma exacerbation or were HCP experienced with caring for patients with asthma in either the ED or primary care setting. Interviews were analysed with reflective thematic analysis.

Results: Key themes across the HCP were recognising the ED as an opportunity to optimised asthma control and 'concerns of tensions in capacity'.  Patient themes included a 'reliance on salbutamol' and dependancy concerns about steroids, but a willingness to trial maintenance and reliever therapy. Patients fundamentally trust the HCP to recommend appropriate treatment and support.

Conclusion: Patients and HCP have a willingness to try new inhalers prescribed in ED to optimise asthma control but highlighted need for support with the change ? including access to information to take home and follow-up support (patients) and clear guidelines (HCP).