The respiratory charity Asthma UK has published a report claiming that tens of thousands of people with asthma in the UK are not getting the right medicines to safely control their condition.
Wessex AHSN is an organisation working towards improving the health of the region by linking quality improvement in the NHS with research and innovations. Our Respiratory Quality Improvement Programme welcomes the findings of the Asthma UK report. Many of our projects are in direct response to last year’s National Review into Asthma Deaths and we see that there is still complacency within healthcare systems, patients and the public around asthma.
Asthma is a disease characterised by inflammation of the airways. If untreated, the inflammation can cause symptoms such as cough, wheeze and breathlessness. This increases the chance of a flare up (exacerbation) and increases the risk of being admitted to hospital and life-threatening asthma. Long standing inflammation can also cause damage to the lungs later in life.
Reliever inhalers (usually blue) help to treat the symptoms of asthma but do not treat the inflammation. Therefore the risk of having serious problems continue. It is important that people with asthma symptoms use steroid inhalers regularly to treat the inflammation and reduce the risks of symptoms, flare-ups and life threatening attacks.
To be considered well controlled, patients with asthma will:
- use their reliever inhaler no more than twice in a week
- have no night time symptoms
- have no flare ups (exacerbations)
- be able to do any activity without asthma symptoms limiting them.
Wessex AHSN is supporting projects to achieve these aims, including:
- MISSION Asthma: A two step rapid access service. First clinic involves reviewing and optimising the management of patients with asthma in the community with access to experts in asthma, specialist tests and tailored treatments. The second clinic provides more intensive assessment by a specialist team for the most severely affected patients
- Pharmacists having a greater role in monitoring and improving care for patients with asthma
- Mobile phone technology supporting teenagers with asthma
- A pilot scheme where patients have free preventer inhalers for their asthma
- Improving education and skills around asthma within schools
- Using the Primary Care Respiratory Society EQUIP tools – including identifying and treating uncontrolled asthma
- Helping develop the Wessex Asthma Network so that patients with the most difficult asthma have access to expert opinion and treatments within Wessex.
We suggest:
- Patients and healthcare professionals should understand what poor asthma control looks like and the potential implications of poor control
- All asthma patients should have a self management plan so that they know what action to take if their asthma is poorly controlled
- Healthcare professionals should assess asthma control regularly and treat poor control aggressively according to the BTS/SIGN Guidelines
- Organisations should put systems in place to identify patients with poor control of their asthma for example when patients are ordering any reliever medication
- Patients should have their asthma reviewed by someone experienced in managing asthma when their disease is uncontrolled or after an exacerbation (whether seen in out of hours, A+E, hospital or primary care)
- GP practices and community pharmacists should perform an audit to identify patients with asthma using more than 12 reliever inhalers per year and arrange a review of their disease
- GP practices and community pharmacists should perform an audit to identify patients with asthma who are prescribed a long acting bronchodilator without inhaled corticosteroids and those who are prescribed a long acting bronchodilator and not using inhaled corticosteroids regularly.
The Asthma UK report and accompanying press release are available to download below, in addition to clinical advice for health care professionals. Should you have any questions, please contact Rachel Dominey, Senior Projects Manager for Wessex AHSN’s Respiratory Quality Improvement Programme, at rachel.dominey@wessexahsn.net or on 07990 002107.
