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Suffer From Asthma? Get A Review PDF Print Email

What inhaler are you using? There are potentially tens of thousands of asthma sufferers not getting the right medication or the correct medication to keep their asthma safely under control.


No asthma sufferer is in immediate danger however, the charity Asthma UK, analysed nearly 100,000 patient records says lives are at risk as some people are taking the wrong types of inhalers.


Everyone should check which inhaler they are prescribed and how often they use them.


Some health professionals aren’t spotting the warning signs that asthma could be spiralling dangerously out of control.

No asthma patient should be prescribed a long-acting reliever inhaler without being given a preventer inhaler too, for example.

Anyone who is using 12 or more short-acting reliever inhalers a year should see their doctor because it means their condition is not under control and needs other medication.


Likewise, anyone who is using their reliever inhaler - which is usually blue in colour - more than three times a week and has not had a recent review should contact their GP or Pharmacist.


The analysis was conducted between 2010 and 2013 and involved over 500 doctors surgeries.  5,000 patients had been prescribed more than 12 reliever inhalers over a 12-month period, 1,965 of them without being reviewed by a nurse or doctor.


And 400 patients had been prescribed long-acting reliever medicines without inhaled steroids.


Applying these findings throughout the UK would suggest tens of thousands of people with asthma could have these medication errors, says Asthma UK.

There are about 5.4 million people in the UK on asthma treatment - a million of these are children and we have one of the highest rates of asthma in the developed world.


Dr Mark Levy, GP and author of the National Review of Asthma Deaths, said deaths could be prevented by better disease management.

"We should be assessing and reviewing every patient and reviewing people every time they have an attack.

"A single review once a year is not acceptable," he said.


Prof Russell Viner, of the Royal College of Paediatrics and Child Health, said: "A huge part of this is making sure we intervene early and ensure preventative medication is given as well as used to relieve symptoms in emergencies."


Dr Peter Carter, of the Royal College of Nursing, said: "The role of specialist nurses is vital in supporting better patient and professional education, but the number of specialist nursing posts that have been eroded in recent years is deeply concerning."


The previous National Review of Asthma Deaths (NRAD) report highlighted the need for improvements. Key findings from the report included:

nearly half of those included in the study had not received any medical help during their last attack;

the standard of care received was less than satisfactory in a quarter of those who died;

and there was widespread under-use of preventer inhalers and excessive over-reliance on reliever inhalers.

The Pharmaceutical Services Negotiating Committee (PSNC) which supports and promotes the role of all NHS community pharmacies in England highlighted how community pharmacy could help with many of the NRAD’s recommendations.


Alastair Buxton, PSNC Head of NHS Services, said:


“The NRAD showed once again the need to develop services to better support people with asthma to manage their medicines and conditions. We already have evidence to show that community pharmacy can do exactly that in a way that is convenient for patients and affordable for the NHS and we hope that our report on this topic will help to convince policy-makers and commissioners of that.


Of course what we would like to see is national action to enable community pharmacies across the country to provide the care we describe to asthma patients, and we will continue to make the value of that clear in our ongoing discussions with the NHS and others. However, we recognise the current direction of travel towards local commissioning within the NHS and so we are also looking to work with stakeholders to develop a commissioning framework that could be adopted by CCGs to initiate these sorts of services at a local level. In the meantime, we hope the report may be of use in helping LPCs with any local discussions on community pharmacy asthma care that they have already begun.”


Pharmacy is a good place to seek advice if more convenient than getting to see your GP.  If you haven’t had a review recently ask for an Medicines Use Review (MUR) which are free.  The pharmacist will check your medication on how you are taking it and suggest action if necessary.


Asthma inhalers:

Reliever inhalers, usually blue or green in colour, deliver medication directly into the lungs as you breathe and ease symptoms by relaxing the muscles around the airways to open up the passages


Short-acting relievers include salbutamol and terbutaline


Long-acting relievers include salmeterol, formeterol and tiotropium bromide and should only be used if you've also been prescribed a preventer inhaler

Preventer inhalers, often brown in colour, usually contain a low dose of steroid medicine to prevent and reduce airway swelling and inflammation


Not everyone needs a preventer inhaler - but if you have started on one, it may take days for you to notice any difference. Patients should nonetheless continue using it.