Dr Andy Whittamore is Asthma UK’s Clinical Lead and in-house GP.
Asthma UK’s latest Annual Asthma Survey brings some welcome news. Over three quarters of people with asthma are now having an annual asthma review, with a similar number getting their inhaler technique checked. Also, more people than ever have a written asthma action plan.
Every silver lining has a cloud, however. The overall number of people with a written asthma action plan remains low – while 42% is better than the previous year’s 36%, this still means that more than half of people with asthma still don’t have one. And not having one makes you four times more likely to end up in hospital with an asthma attack.
Poorly controlled asthma
In the survey, 82% of respondents indicated that their asthma is uncontrolled. This is unacceptably high but there is no single explanation for this. Many people experience a poor night’s sleep due to their asthma, find it hard to carry out a daily activity or notice that their symptoms are bad and just accept it. For years there has been huge complacency around asthma with people believing that these symptoms are things they have to live with. That is simply not true.
Most people with asthma should not be limited by their symptoms. They shouldn’t have to accept a bad night’s sleep or struggle with daily activities. These are typical signs that the lungs have hidden, untreated inflammation, meaning that when you come into contact with an asthma trigger such as pollen or cold/flu viruses, your lungs are more likely to react as they are sensitive. This leads to symptoms and increases the risk of a life-threatening asthma attack.
Taking your medicines as prescribed, following a personalised asthma action plan and letting your GP or asthma nurse know if you are getting regular symptoms are all so important in reducing the risk of harm from this inflammation. A reliever gives on-the-spot relief from symptoms, but it can’t do anything about the long term build-up of inflammation in your airways - you need a preventer inhaler for that. Taking your reliever three times a week or more is also a sign that your asthma is not as well managed as it could be and you need to work with your GP or nurse to protect you from the inflammation.
NHS staff can only help you get better when they know something is wrong so unless you tell your GP or asthma nurse, they won’t know. If you notice your asthma symptoms getting worse, you must speak to your GP and get checked to make sure that you are getting the right medicines and that you are taking them in the correct way.
Equally, GPs and community pharmacists need to ask their patients about these symptoms and support people to better manage their asthma. With the right medicines, taken in the right way, the majority of people living with asthma can manage it well and be symptom free.
After an asthma attack
The survey also revealed that of the people who attended hospital or received out-of-hours care for their asthma, only a quarter were booked for a follow-up appointment with their GP or nurse.
Following an acute flare-up of asthma, it is very important that people with asthma have a follow up appointment to ensure that they are improving clinically. This appointment is also an opportunity to improve the management of their asthma, reinforce self-management (including a written asthma action plan) and try to prevent another deterioration.
This is an important part of your care and something you can help with. If you go to hospital for your asthma, make sure that you ask about arranging a follow-up appointment, or make an appointment with your GP or asthma nurse once you’ve been discharged.
In the survey, of those who paid for their own prescriptions, almost two thirds said that paying for these had an impact on their ability to pay for other activities.
If you live in England and you’re getting more than one prescription a month, a prescription prepayment certificate might help to reduce these costs.
Two-thirds of people with asthma are not getting the care they deserve
The overall finding of this survey was that two thirds of people with asthma are still not receiving the basic care they need to manage their asthma. It is worrying that basic care is not being delivered on a consistent basis, because every person with asthma deserves and needs it.
Managing asthma successfully is a partnership between the person with asthma and the NHS. People with asthma need to be given the tools to understand and manage their asthma effectively, and need to seek help earlier when their asthma is not controlled.
Our website can also help you to understand your condition and how best to support yourself whether it be at work, school, or home. The Asthma UK Helpline (0300 222 5800, open Mon-Fri 9am to 5pm) can also provide support and guidance when needed.
Below are three links to help you get the basic care you deserve, and work with your GP or nurse to keep you well: