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asthma manJune 22 2016

Patients with asthma are less likely to require emergency hospital treatment if they have better access to general practices services, a study has indicated.

Analysis of data from 7,806 general practices in England (95%) found there were 3.13 million patients with asthma and 655,570 emergency admissions with asthma. “Admission rates were lower in practices with a higher composite access score (adjusted IRR for 10% change in variable 0.679, 95% CI = 0.665 to 0.708),” says the study in the British Journal of General Practice.

“Admissions were higher in those practices with higher proportions of the practice population who were white, and in practices with lower performance in the Quality and Outcomes Framework indicator ‘asthma review in past 15 months’ (Asthma 6).”

The researchers estimate that a higher access score of 10% was associated with a decrease of 17,837 admissions per year for these practices, with an assumption that the associations were causal. The researchers based at Norwich Medical School, Norfolk, have recommended that policymakers should look at improving primary care access as it may help prevent emergency hospital admissions for asthma.

Asthma UK has suggested the research reflects its awareness of patients’ experience of GP practices. Dr Samantha Walker, Director of Research and Policy at Asthma UK, said: “People with asthma tell us that it can be difficult to book an appointment with their GP or nurse, so this new research shows how absolutely vital it is that they persist, are not fobbed off and are able to get the help they need.

“Asthma is a highly variable condition and symptoms can worsen very quickly. Three people die of an asthma attack every day and two of these deaths are preventable with better basic care. It’s essential that access to GP care for asthma patients improves to keep them out of hospital. One in six people who receive emergency treatment for an asthma attack need emergency treatment again within two weeks.”

RCGP Chair Maureen Baker has said that GPs are highly trained to care for patients with asthma, but more investment is needed to meet demand. “We are concerned that some patients with asthma are finding it difficult to get an appointment with their GP practice but demand for family doctor services has rocketed, while investment and GP numbers have not kept pace,” she said.

She called on the Government to implement as a matter of urgency the pledges made in the GP Forward View to invest in primary care, “so we can recruit, retain and return as many GPs across the UK to ensure we can continue to deliver the care our patients - particularly those with long-term conditions such as asthma - need and deserve.”

Dr Baker reminded GPs that the RCGP has also produced a free and comprehensive online training course “to support GPs and trainees in improving their skills in caring for patients with asthma.” The training has been developed with the Primary Care Respiratory Society and Education for Health.

Links:

R Fleetcroft et al. ‘Emergency hospital admissions for asthma and access to primary care: cross-sectional analysis’. BJGP. Published online June 20 2016.

Asthma UK comment

RCGP response

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