Nasser Shuaib
Department of Allergy and Respiratory Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, CB2 0QQ, UK.
Respir Res. 2016 Jul 19;17(1):87. doi: 10.1186/s12931-016-0393-9.
Asthma deaths are a barometer of the quality of asthma care. The principal care for patients with severe asthma is often a joint partnership between primary and secondary services. Communication between the two services determines the effectiveness of treatment. Undertaking an audit on asthma in either primary or separately in secondary care is a relatively straightforward process. However, when the audit spans both primary and secondary care in a country as large as the United Kingdom which is further sub-divided into the separate healthcare systems of England, Wales, Scotland, and Northern Island, then the audit becomes considerably more challenging. The National Review of Asthma Deaths (NRAD) reported in May 2014 was a confidential enquiry tasked with identifying circumstances surrounding asthma deaths across the whole of the UK, in order to ascertain avoidable factors and make recommendations to improve care and reduce future asthma deaths (Why asthma still kills: the National Review of Asthma Deaths (NRAD) Confidential Enquiry report, 2014, http://www.rcplondon.ac.uk/sites/default/files/why-asthma-still-kills-full-report.pdf ). The idea for NRAD arose from a longstanding East of England confidential enquiry started in 1988 by Dr Brian Harrison and then handed onto me in 2001 until funding for the national review of asthma deaths was secured in 2010.
哮喘死亡人数是哮喘护理质量的一项指标。重度哮喘患者的主要护理通常是初级和二级医疗服务机构之间的联合协作。这两种服务之间的沟通决定了治疗效果。在初级医疗或单独在二级医疗中对哮喘进行审核是一个相对简单的过程。然而，当审核范围覆盖像英国这样幅员辽阔且又进一步细分为英格兰、威尔士、苏格兰和北爱尔兰各自独立医疗体系的国家的初级和二级医疗时，审核就变得极具挑战性得多。2014年5月发布的《哮喘死亡情况国家审查报告》（NRAD）是一项机密调查，其任务是查明全英国范围内哮喘死亡的相关情况，以确定可避免的因素，并提出改善护理及减少未来哮喘死亡人数的建议（《为何哮喘仍会夺命：哮喘死亡情况国家审查报告（NRAD）机密调查报告》，2014年，http://www.rcplondon.ac.uk/sites/default/files/why-asthma-still-kills-full-report.pdf ）。NRAD的构想源于1988年由布莱恩·哈里森医生发起的一项长期的英格兰东部机密调查，该调查于2001年移交给我，直至2010年获得哮喘死亡情况国家审查的资金。
