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May 2020

Basic care failings for 60% of asthma patients

Six out of ten people with asthma are not receiving basic asthma care, and almost half of asthma patients do not have a personalised asthma action plan (PAAP), a charity has revealed.

The latest survey from Asthma UK has also revealed inequalities in asthma severity and symptoms between richer and poorer sections of the population, with twice as many people in the top income band having well controlled asthma compared with those in the lowest income group. Almost half (47%) of people with asthma from lower income households (below £20,000) have had more than two asthma attacks in the past 12 months.

The report, The Great Asthma Divide, states: ‘The stark link between low income and poor asthma outcomes is a gross injustice, and urgent action is needed to address it.’

The survey suggests that access to basic asthma care by household income is not the main factor in worse outcomes: although people from lower income groups seem to have the same access to basic asthma care, the quality of reviews is poorer. They are less likely to be asked about their symptoms, their inhaler use is not assessed and their adherence to their preventer inhaler is less likely to be discussed.

More than 3 million people with asthma are not receiving all elements of basic asthma care (an asthma review, an inhaler technique check and a written PAAP) and for the first time in 7 years, there has been no year on year improvement in access to basic care. When people do receive a review, Asthma UK claims these are not meeting the quality standards expected. Of those patients who have a review, fewer than half are asked about recent asthma attacks or use of reliever inhalers. Only one in three people who received emergency asthma care had a follow up appointment within two working days.

Asthma UK Chief executive Kay Boycott said: ‘We are concerned that even when people do have an asthma review, it is too often a box-ticking exercise. It’s crucial that everyone gets a good quality review, personalised to their needs, so that everyone, regardless of background can self-manage their asthma well and reduce the burden of asthma attacks and avoidable admissions.

‘The NICE guidelines for managing severe asthma during coronavirus recommend following a written asthma action plan – something that 48% of people with asthma are still not receiving.

‘The COVID-19 epidemic has also highlighted the problems the NHS has had in identifying people with severe asthma, and better provision of basic care would have helped this task.’

Asthma UK. The Great Asthma Divide; May 2020

  • Chiesi has released a different version of Clenil® Modulite® 100mcg (beclometasone) to help overcome shortages following significant increases in demand for ‘preventer’ inhalers, as reported in Practice Nurse last month. The new version of Clenil has a yellow cap rather than brown, and no dose counter, but the medication and style of device (pressurised metered dose inhaler [pMDI] remain unchanged, so there is no need to change the way prescriptions are written or for patients to change their usual regimen. However, Chiesi has renewed its appeal to prescribers only to write monthly prescriptions and not to prescribe greater quantities than usual, to avoid further supply shortages.

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