Preventing avoidable asthma deaths.

The UK has one of the highest death rates in Europe from asthma, with more than 20 people dying from the disease each week. Across the UK there is a five-fold variation in the number of hospital admissions for asthma almost certainly explained in part by variations in delivery, uptake and organisation of care. Deaths from asthma are frequently avoidable the findings from the National Review of Asthma Deaths have confirmed. A total of 276 cases were considered by the confidential enquiry panels and 195 confirmed as asthma deaths. Major avoidable factors were judged to be present in 60% of cases. Key findings from the report include: Almost half the patients (45%) died without seeking medical help or before help could be provided; 10% died within 28 days of discharge from hospital; 21% had attended A&E with asthma in the previous year; and only 23% had a personal asthma action plan. Over-prescription of short-acting bronchodilators and under-prescription of preventer inhalers was common. Every general practice should have a designated, named clinical lead for asthma services. Patients with asthma should be referred to a specialist asthma service if they have required more than two courses of systemic corticosteroids, oral or injected, in the previous 12 months or management using BTS steps 4 or 5 to achieve control. Any patient admitted to hospital or attending A&E with asthma should be reviewed, and control optimised, within a week of discharge. All asthma patients should have a written personal asthma action plan and should have a structured review by a healthcare professional with training. in asthma at least annually.