Abstract

Background: Asthma is a chronic respiratory condition, both smoking and vaping are associated with poorer outcomes. Recording these factors helps target cessation support and improve overall care.
Aims: This audit assessed if asthma prescribing aligned with 2024 NICE and local Nottinghamshire guidelines, compared with a previous audit, and if vaping and smoking was appropriately coded.
Methods: Patients with a new diagnosis of asthma in the last 18 months were retrieved via a SystemOne search. Forty-seven patients were retrieved and grouped into children under 12 (n=15), children over 12 (n=2) and adults (n=30). Patients were excluded if asthma diagnosis was not confirmed (n=3). Prescribing was compared with Nottinghamshire Prescribing guidelines, and smoking / e-cigarette coding and notes were reviewed. Results were compared from a previous audit.
Results: Prescribing improved from 47% in previous audit to 83% in under 12s and over 12s 86%. Smoking coding improved by 13%, however, the proportion of new asthmatics who were smokers increased. 46% of adults did not have documented vaping status and 75% of children did not have smoking exposure coded.
Conclusion: This practice improved its prescribing as of the new 2024 guidelines, but vaping documentation remains poor in both children and adults, and childhood smoking exposure reporting is very poorly documented. A prompt in SystemOne to record vaping status in all asthmatics, alongside reinforcement of smoking exposure coding in all childhood asthmatics may improve documentation in the future. More smoking cessation support is needed at this practice.