From: An imperfect “PAST” Lessons learned from the National Review of Asthma Deaths (NRAD) UK
Risk Factor | Recommendation |
---|---|
1. 45 % died at home without calling for help and Personal Asthma Action Plans (PAAPs) had only been issued to 23 % | All patients with asthma to be issued with PAAPs to include |
• asthma triggers, | |
• current therapy, | |
• advice on treatment escalation and | |
• how to call for help | |
2. Failure to phenotype asthma or identify triggers in >51 % | Asthma clinical phenotyping to identify likely triggers and underlying mechanism of asthma |
3. No evidence of a review in general practice in the last yr for 43 % | Structured annual review of asthma control preferably timed a month before expected seasonal exacerbation |
4. 10 % died within 28d of hospital discharge and 21 % died within 12mo of attendance in ED | Follow-up arranged following every attendance in ED and secondary care follow-up after each hospital admission for asthma |
5. Excessive prescribing of SABA (39 % issued with >12 devices in previous 12mo) inadequate uptake of ICS with 38 % issued <4 devices in previous 12 mo | Electronic surveillance of inhaler prescribing in primary care to identify those prescribed >12 short-acting beta-agonist or < 4 corticosteroid inhaler devices in previous yr |