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A review of asthma care in 50 general practices in Bedfordshire, United Kingdom

Mark Levy, Fiona Garnett, Adedayo Kuku, et al.
NPJ Prim Care Respir Med 2018;28:29

The National Review of Asthma Deaths (NRAD), published in 2014, highlighted that 90% of asthma-related deaths occurring between 2012 and 2013 were associated with poor asthma management in healthcare. This included, but was not limited to, failure to recognise asthma risk, over-prescription of short-acting beta2-agonists (SABAs) and insufficient prescription of inhaled corticosteroid (ICS) preventer inhalers.

Based on this, the Bedfordshire Clinical Commissioning Group initiated a quality asthma audit across 50 practices in Bedfordshire between 2015 and 2016. Results demonstrated a broad variation in the care provided between these practices, including marked variation in the number of patients being provided personal action plans (ranging from 0% of patients in some practices to 98% of patients in others). Excessive prescriptions of SABAs were also recorded, with 1 in 20 patients being prescribed more than 12 SABA inhalers in the previous year.

In conducting this audit, researchers identified difficulties in gathering the information required to document patients at risk using the current systems in place. Conclusions highlighted that modifications are required to these systems to ensure patients are effectively managed and the risk of an asthma attack or related death is reduced.

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