27 February 2013

Improving the Diagnosis and Treatment of Asthma

NICE has developed a quality standard for asthma that can help GPs improve the diagnosis and treatment of people with the condition.

Around 5.4 million people in the UK currently receive treatment for asthma, 1.1 million of whom are children.

The NICE quality standard for asthma contains 11 statements of measures for high quality care, such as ensuring that patients with newly diagnosed asthma are diagnosed in accordance with BTS/SIGN guidance.

NICE says it is important to clearly record the basis on which the diagnosis of asthma is made, because the process may have implications for the future management of the condition.

The standard includes a measure for the number of adults with new onset asthma assessed for occupational causes.

Occupational asthma is the only form of the condition that can be potentially cured by removing the person from exposure to the trigger. NICE says that GPs need to be able to recognise symptoms suggestive of occupational asthma, so that they can ensure appropriate referral and treatment.

Patients with asthma should receive a structured review at least annually. This is because structured annual reviews can lead to improved clinical outcomes for those with the condition, such as reduced attendance in accident and emergency departments, and improved symptom control.

The quality standard recommends that GPs give patients training on their inhaler technique before starting any new inhaler treatment. GPs should follow up every patient who suffers an acute exacerbation of asthma within two working days, according to a statement in the quality standard.

NICE says that follow-up appointments are important to explore the possible reasons for the exacerbation, and the actions needed to reduce the risk of further acute episodes.

Dr Penny Woods, Chief Executive of the British Lung Foundation, said: "With mortality 50 per cent higher than the EU average, and hospital admissions significantly more common than elsewhere in the developed world, most people working in respiratory disease today will recognise that there is considerable scope for improving asthma care in this country.

"We hope that, by outlining priority areas for quality improvement, this new quality standard document will mark a significant step towards the kind of world-class care everyone working in the industry wants for the 4.5 million people living with asthma across England."

Emily Humphreys, Head of Policy and Public Affairs at Asthma UK, said: "We're delighted that a quality standard is now in place for asthma. This will really help to improve the quality of care provided for one of the most common long-term conditions - so it's no exaggeration to say that if this is successful, it could change millions of lives.

"We're particularly pleased to see the inclusion of personal asthma action plans. People who have an action plan are four times less likely to need to be admitted to hospital, but only a tiny proportion of people with asthma are currently offered one.

"Making sure this is implemented will be the next key test of asthma care in the NHS," she added.