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    Tuesday, 31 July 2018 15:31
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Umesh Modi is a chartered accountant, and Pamini Jatheeskumar is a chartered certified accountant at Silver Levene...
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Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead pharmacist, Health and Wellbeing Directorate, Public Health England
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asthma manJune 17 2015

Unsafe prescribing is continuing to put tens of thousands of asthma patients at risk, Asthma UK is warning.

New analysis, based on data from over 500 UK GP practices, “reveals 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,” says the charity.

“In addition, the report indicates 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.”

Asthma UK has issued the warning one year on from the publication of the National Review of Asthma Deaths. This had highlighted that prescribing errors were present in 47% of asthma deaths.

The new report’s findings are based on data from the Optimum Patient Care Research Database, which was analysed by Asthma UK, in collaboration with Optimum Patient Care Ltd and the Respiratory Effectiveness Group.

Asthma UK says that if someone with asthma is prescribed more than 12 short-acting reliever inhalers in a year (using it more than three times each week) without seeing a doctor, “it is a key indicator that they are not managing their condition and that their treatment needs reviewing.”

Kay Boycott, Chief Executive of Asthma UK, commented: “It is simply unacceptable that the lives of people with asthma are being put at risk because of unsafe prescribing. The UK has some of the highest mortality rates for asthma in Western Europe and the levels of unsafe prescribing identified in our report today must be stopped.

“It is crucial that healthcare professionals review their systems and urgently recall patients who have been prescribed long-acting reliever inhalers on their own without a steroid preventer, or not as a combination inhaler. NHS bodies must ensure systems are in place to stop unsafe asthma prescribing from happening and implement all the recommendations from the National Review of Asthma Deaths to improve patient safety and end complacency in asthma care.”

Asthma UK is drawing attention to certain medications in particular. If a patient’s inhaler contains salmeterol, formoterol or tiotropium bromide as the only active ingredient, and the patient is taking this without a steroid preventer inhaler, or not as a combination inhaler, “they need to contact their GP right away,” said Ms Boycott.

Alastair Buxton, PSNC’s Director of NHS Services, commented: “Asthma UK’s report is a reminder of what still needs to be done to improve the support that is given to people with asthma. Community pharmacy is well placed to offer services to help people with asthma better manage their condition and its associated medicines and, with general practice currently facing immense pressure, community pharmacy can also offer access to services over longer opening hours often with no appointment needed.”

PSNC responded to the NRAD last year, and points out there is already evidence to show that pharmacy teams are able to offer an asthma management service that is both convenient for patients and affordable for the NHS. “Therefore, we are currently developing a number of prospectuses to support Local Pharmaceutical Committees in initiating discussions with local commissioners on using community pharmacy to deliver a range of health services, including asthma management,” said Mr Buxton.

“We are also working collaboratively with Asthma UK and NHS Specialist Pharmacy Services to develop audit templates which will allow pharmacy teams to play their part in tackling the prescribing issues that Asthma UK’s report has highlighted.”

Dr Mark Levy, GP and author of The National Review of Asthma Deaths, added: “Asthma UK’s report is welcome as it echoes the findings from the National Review of Asthma Deaths. There is widespread failure to recognise risk of attacks and therefore asthma death. Yet the reality is that deaths can be prevented when symptoms are managed effectively, with safe use of asthma medicines and in partnership with the patient.”

Links:

Asthma UK announcement    

Asthma UK: ‘Patient safety failures in asthma care: the scale of unsafe prescribing in the UK’ report    

PSNC comment     

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