A “step-change” is needed in asthma treatment, with better training for practice nurses and more specialist nurse posts, experts have said in the wake of the largest ever national study of deaths from the condition.
The National Review of Asthma Deaths, published on 6 May – World Asthma Day – by the Royal College of Physicians, called for an “end to complacency” around asthma care to avoid unnecessary deaths from the condition.
“It’s time to end our complacency about asthma, which can, and does, kill”
The review examined 195 cases where patients were recorded as dying from asthma. It concluded education improvements were needed so both patients and clinicians were better at recognising the signs of asthma deterioration and at acting quickly when faced with a potentially fatal exacerbation.
Every hospital and GP practice should have a named clinician for asthma services, and all patients should be given a personal asthma action plan, it added.
The review found 45% of the patients did not have any clinical help during their final asthma attack. In addition, it judged the standard of care received in a quarter of those who died as less than satisfactory and said there was “room for improvement” in care received by 83%.
Triggers for asthma attacks had not been documented in more than half of cases, and there was also widespread under-use of preventer inhalers and excessive over-reliance on reliever inhalers.
“This review should serve as a wakeup call for everyone involved in providing care to patients with asthma”
Meanwhile, 10% died within one month of discharge following treatment for asthma and at least 21% had attended an emergency department once or more in the previous year.
Dr Kevin Stewart, clinical director of the RCP’s Clinical Effectiveness and Evaluation Unit, said: “It’s time to end our complacency about asthma, which can, and does, kill.
“We haven’t paid enough attention to the importance of good routine asthma care by clinicians with the right training and experience and the part patients themselves play in this.”
The Association of Respiratory Nurse Specialists and Royal College of Nursing called for a “step change” in the way asthma was treated and understood.
In particular, they called for investment in education for non-specialists such as practice nurses, and the appointment of a nurse lead for asthma in every clinical commissioning group.
ARNS chair Rebecca Sherrington said: “Not delivering these improvements is simply not an option if we are to prevent more individuals dying needlessly.”
Monica Fletcher, chief executive of the nursing charity Education for Health, added: “The results of this review should serve as a wakeup call for everyone involved in providing care to patients and their families with asthma.”
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