Perceptions on home-administration of biologics in severe asthma: an international qualitative study.

Background: Biologics are an effective therapy for severe asthma. Home-administration of biologics by patients is likely to facilitate their accessibility. Yet, little is known about patients’ and health care providers’ (HCPs) perceptions regarding home-administration of biologics. Objective: The aim of this study is to create more insight into the perceptions and experiences of patients and HCPs regarding home-administration of biologics in the treatment of severe asthma. Methods: A qualitative international study was performed in the Netherlands, United States, Australia, and United Kingdom. In each country, two focus groups (FGs) were held with potential and current users of biologics at home. Prior to the FGs, patients were prompted with themes on online forums. For triangulation purposes, interviews were held with HCPs to discuss salient findings from forums and FGs. Data were analyzed with qualitative content analysis. Results: In total, 75 patients participated in the forums, of which 40 participated in the FGs. Furthermore, 12 HCPs were interviewed. The following overarching themes were identified: living with severe asthma; practical aspects of using biologics; the role of HCPs regarding biologics; social support from family, friends, and others; effectiveness of biologics and other treatments; side-effects of biologics. Conclusions: This study showed that for those using biologics for severe asthma, the benefits of home-administration of biologics usually outweigh inconvenience and side-effects. Guided practice, accessible support contact, and monitoring including social support, should be central in the transition from hospital to home-administration of asthma biologics.