Unsafe asthma prescribing 'must end'

Unsafe asthma prescribing 'must end'

The charity Asthma UK, which analysed nearly 100,000 patient records to reach this estimate, says lives are at risk. It found some patients had been put on the wrong types of inhalers. And some medics were not picking up on warning signs that asthma could be spiralling dangerously out of control. Asthma UK insists that no patient is in immediate danger, but warns that they should check which inhalers they have been prescribed and how often they use them. No asthma patient should be prescribed a long-acting reliever inhaler without being given a preventer inhaler too, for example.

And any person who finds that they use 12 or more short-acting reliever inhalers in a year must see a 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 with their doctor should contact their GP.

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.

In the audit of more than 500 GP practices carried out between 2010 and 2013, 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 this incidence to the whole of the UK suggests 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. Experts say the findings echo those of a report published a year ago - the National Review of Asthma Deaths. The UK has one of the highest rates of asthma prevalence, hospital admissions and mortality 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."

Nurses called for better asthma training. 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 Medicines and Healthcare Products Regulatory Agency said it provided prescribing advice on its website.

A spokesman said: "Guidance for prescribers has been published in the MHRA's safety bulletin, Drug Safety Update, and product information for prescribers and patients has been updated accordingly."


By Michelle Roberts

BBC News, Tuesday 16 June 2015

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