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Clinicians can learn from patients who have had asthma attacks

Hospital admissions were reduced by 16% after practices in Harrow took on board the lessons learned from an audit of 291 children and young people who had had asthma attacks.

This shows that clinicians can use the learning from patients who have had asthma attacks to reduce the risk of further events, concludes Dr Mark Levy, GP and Clinical Lead, National Review of Asthma Deaths, who led the audit.

The audit was funded as a Local Incentive Scheme (LIS) aimed at improving quality health care delivery.

In a paper in NPJ Primary Care Respiratory Medicine, Dr Levy says an asthma attack or exacerbation signals treatment failure. Most attacks are preventable and failure to recognise risk of asthma attacks are well recognised as risk factors for future attacks and even death.

Of the 19 recommendations made by the United Kingdom National Review of Asthma Deaths (NRAD) only one has been partially implemented—a National Asthma Audit; however, this hasn’t reported yet.

Dr Levy comments that in Harrow, two years after the publication of the NRAD report it was surprising that risks for future attacks were not recognised, that few patients were assessed objectively during attacks and only 10 per cent of attacks were followed up within two days. However, he said it was encouraging that hospital admissions of children and young people following the audit were reduced by 16% with clear benefit for patients, their families and the local health economy.

“This audit has provided an example of how clinicians can focus learning on patients who have had asthma attacks and utilise these events as a catalyst for active reflection in particular on modifiable risk factors. Through identification of these risks and active optimisation of management, preventable asthma attacks could become ‘never events’, he writes.”

Download a table summarising the key messages for practices from the audit and suggested actions and changes in management

Read the full paper

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