National Review of Asthma Deaths

The National Review of Asthma Deaths was the first fully comprehensive review of deaths from asthma across the UK. Led by the Royal College of Physicians (RCP), and conducted between February 2012 – 2013, the final report has recently been published, making 19 recommendations for improvements in care.

Primary Care Training Centre tutor Andrew Booth chaired some of the review panels, formed by healthcare professionals from both primary and secondary care.

Some of the most important findings identified by the Primary Care Respiratory Society were:

  • In 43% there was no evidence of an asthma review in the previous 12 months
  • 22% of those who died had missed a routine GP appointment.
  • 24% had received a personalised asthma action plan, though QOF recommends this as part of a regular review.
  • 50% of the deaths took place between 8am and 6pm when GP practices are open, implying that these patients were not aware of how ill they were until it was too late to get help.
  • 21% of those who died had attended an Emergency Department (ED) in the previous 12 months, and over half of these had presented more than once. Practices need to regard non-attendance at routine reviews, and ED visits as indicators of risk.
  • 86% of those who died were receiving ICS as single agents or in combination with long acting beta-agonists. However, 80% of these had received fewer than twelve inhalers a year and 38% had received fewer than four inhalers, which suggests considerable under-use.
  • 56% of those prescribed SABAs had had more than six and 39% had received more than twelve inhalers in the 12 months prior to death, which constitutes significant over-use and is an indicator of risk.

The full report from the RCP can be found HERE.

The Primary Care Respiratory Society are conducting an audit, which you can participate in, to see how your own practice is performing on achieving concordance with asthma medication. You can start the audit HERE.

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