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The National Review of Asthma Deaths (NRAD)

Posted on: 1 Feb 2019

This document was originally published in May 2014.

Avoidable factors play a part in up to three-quarters of asthma deaths.

The aim of the National Review of Asthma Deaths was to understand the circumstances surrounding asthma deaths in the UK. As a result, it hoped to identify avoidable factors and make recommendations to improve care and reduce deaths.

This report is the first investigation into asthma deaths in the UK and the largest such study worldwide to date. It covers work undertaken over a three-year period, and was one part of the Department of Health in England’s Respiratory Programme.

A data analysis of 195 people who died from asthma during the review period was conducted, in order to determine the key findings.

  • During the final attack of asthma, 45% died without seeking medical assistance or before emergency medical care could be provided.
  • 10% died within 28 days of discharge from hospital after treatment for asthma.
  • 23% had been provided with personal asthma action plans.
  • 43% had not received an asthma review in the last year of their life.
  • Exacerbating factors were documented for 50%: triggers were not documented in the other half.
  • Factors that could have avoided death in relation to the health professional’s implementation of asthma guidelines were identified in 46%, including lack of asthma expertise and lack of knowledge of UK asthma guidelines.

The report made several recommendations on the basis of these findings.

  • Patients with asthma must be referred to a specialist asthma service if they required more than two courses of systemic corticosteroids, oral or injected, in the previous year.
  • Avoidable factors play a part in up to three-quarters of asthma deaths.
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