Almost 23,000 people with asthma may have been unsafely prescribed medication for their condition in recent years that puts them at a higher risk of death, according to data analysis by a charity.
Asthma UK’s review of sample GP data from 2010 to 2013 suggested that almost 21,000 adults and 2,000 children across the UK may have been given long-acting reliever inhalers alone – instead of in combination with the required inhaled steroids.
“It is crucial that healthcare professionals urgently recall patients who have been prescribed long-acting reliever inhalers on their own”
The charity described such prescribing as “unsafe”, “unlicensed” and as “putting the lives of patients at risk”.
It made the claims today in a report called Patient Safety Failures in Asthma Care: the scale of unsafe prescribing in the UK.
The data on almost 95,000 people across more than 500 GP practices also found that in an “unacceptably common” number of cases patients were prescribed more than the maximum of 12 reliever inhalers per person a year.
In addition, nearly 40% of the 5,000 people in the data sample that had been prescribed more than 12 reliever inhalers in a year had not been reviewed by a healthcare professional.
Asthma UK said that when applied to the UK population, this indicated almost 107,000 people with asthma may have been prescribed excessive amounts of reliever medication without a review.
This number potentially included 10,000 children under the age of 15, putting them at higher risk of a life-threatening asthma attack.
“Correct training is crucial and should encompass diagnosis, the understanding of asthma guidelines in practice, and the best evidence for long term treatment”
The report noted that there may be legitimate reasons for prescribing more than 12 reliever inhalers – such as children requiring spare devices for school.
But it added: “Systems should be in place which alert doctors, nurses and pharmacists to these prescribing patterns, to help them identify whether people are at high risk and need an urgent review, or whether their need for multiple inhalers is valid.”
Asthma UK pointed to a lack of training and education, inadequate systems for identifying and preventing human errors, and a culture that fails to acknowledge the seriousness of asthma as possible reasons for the prescribing errors.
It has urged healthcare professionals to implement recommendations from the National Review of Asthma Deaths, which took place last year, “as a matter of urgency” to protect people with asthma in the UK from avoidable harm and preventable deaths.
Kay Boycott, chief executive of Asthma UK, said: “The UK has some of the highest mortality rates for asthma in Western Europe and the levels of unsafe prescribing identified in our report today must be stopped.
“It is crucial that healthcare professionals review their systems and urgently recall patients who have been prescribed long-acting reliever inhalers on their own without a steroid preventer, or not as a combination inhaler.”
The Association of Respiratory Nurse Specialists and the Royal College of Nursing said the report demonstrated the need for employers to ensure better provision of training for nurses and other primary care staff.
Matthew Hodson, ARNS chair, said: “Correct training is crucial and should encompass the correct diagnosis, the understanding of asthma guidelines in practice, and the best evidence for long term treatment.
“Respiratory nurses have a role to support this but so much of asthma care is undertaken in primary care that all staff have a responsibility to ensure evidence-based care is followed and all employers should ensure that staff can access asthma training,” he said.
Peter Carter, chief executive and general secretary of the RCN, added: “The role of specialist nurses is vital in supporting better patient and professional education, but the number of specialist nursing posts that have been eroded in recent years is deeply concerning.
“The NHS as a whole needs to ensure that staff have the opportunity to update their skills and knowledge regularly, and should have time to carry out proper reviews of the treatment for all their patients.”