The National Review of Asthma Deaths in 2014 highlighted prescribing errors in nearly half of asthma deaths in primary care (47%). Asthma UK has subsequently analysed data from over 500 UK GP practices which shows these prescribing errors were just the tip of the iceberg.
Our analysis revealed there is evidence that over 22,000 people with asthma in the UK, including 2,000 children, have been prescribed medicines (long-acting reliever inhalers) in a way that is so unsafe they have a black box warning in the USA due to the risk they pose to the lives of people with asthma.
Our report also indicated that almost 100,000 people with asthma have been prescribed too many short-acting reliever inhalers (more than 12 in a year) without national clinical guidelines being followed, leaving them at risk of life threatening asthma attacks.
Using a short-acting reliever inhaler, usually blue, more than three times a week is a strong warning sign of poor asthma control and a predictor of future asthma attacks. These patients are at increased risk of an asthma attack and should be invited in for a review with a GP or nurse.
Complacency in asthma care must end. Governments around the UK need to put measures in place to prevent such practice from occurring, and implement all the recommendations from the National Review of Asthma Deaths to protect people with asthma from avoidable harm and preventable asthma deaths.
- People with asthma on long-acting reliever inhalers (long-acting beta agonists (LABA) and/or long-acting muscarinic receptor antagonists (LAMA)) with no inhaled corticosteroid (ICS), should seek an urgent review of their medication.
- Anyone who has been prescribed more than 12 short-acting reliever inhalers in a year, should have an asthma review in the very near future.
- New prescribing systems should be used wherever possible to set up alerts for asthma reviews.
- Clinicians should work with their practice IT/audit lead to run an auditto highlight patients with asthma on long-acting reliever inhalers (LABA and/or LAMA) or being prescribed high numbers of short-acting reliever inhalers who should have an urgent asthma review:
- data should be extracted for the previous 12 months, for people who have current diagnosis of asthma
- patients who have not had at least one prescription of asthma medication in the past year, have a resolved case of asthma, have a diagnosis of COPD or are under 4 years of age should all be excluded.