Asthma patients are missing vital annual reviews

A new review of GP data conducted by Asthma UK makes for an alarming reading, showing that over a million people suffering with the lung condition are not having vital annual check-ups – important in assessing if asthma medicine is being used in the correct way, to see if lung function has got better or worse, and to check if patient’s asthma inhalers are the most appropriate ones for them.

The new research conducted by Asthma UK discovered that 31% of asthma patients had not received an essential annual review to look at the suitability of their prescribed asthma medicine.

The charity analysed GP statistics from 2012/13 and found that 3,359,612 people in England were scheduled for an asthma review, however 1,025,539 patients had not attended.

Guidance published by the NHS advises all asthma patients to attend their yearly checks as well as keep an asthma action plan and have their inhaler technique looked at. For instance, GPs and asthma nurses need to see if the patient ‘test’ the device first, if the patient shakes the inhaler before using, is breathing out normally, holding the inhaler upright with lips sealed around it, using one actuation only per inhalation, and if the patient is holding their breath for 10 seconds (if possible).

Patients who aren’t using their inhaler correctly may find they are overusing the blue reliever inhaler because they are not sufficiently ingesting the drug to start with. Others find they may be using their relievers far more frequently than previously, and more often than not, these people are not bothering to use the brown preventer inhalers which are massively important in building a long-term improvement.

For example, it can take between 7 to 14 days for the brown preventer to build up its effect, or sometimes as much as six weeks, and will not give immediate relief of symptoms like the blue inhaler offers. The benefits of the brown inhaler build up over time and will decrease the chance of an asthma attack/symptoms occurring by slowly building resistance to triggers.

A recently conducted UK-wide National Review of Asthma Deaths found prescribing mistakes in almost half (47%) of asthma deaths and the quality of care could have been improved in a staggering 83% of the deaths.

The National Review also discovered that only 57% of these patients had received an annual asthma review in the last year of their life. From the other 43% that did have a review, many of these had not even included key components.

Dr Samantha Walker, Deputy Chief Executive of Asthma UK, was speaking on the finding that a quarter of people with asthma in the North of England had not had a review of their condition.

She said: “The fact that over a quarter of people with asthma in the North of England are not getting their medicines checked at their annual review is no doubt contributing to the rising NHS spend on asthma and putting people’s lives at risk. With the worrying scale of prescribing errors identified by the National Review of Asthma Deaths, it’s vital that doctors and nurses do everything they can to follow up with patients to review their medicines, especially as asthma can vary hugely over the year. We’re keen to understand where further improvements can be made to asthma care in the North of England so urge people with asthma to complete our survey www.asthma.org.uk/compareyourcare to find out how their care compares to national standards”.