Why asthma still kills

Anna MurphyBy Professor Anna Murphy, Consultant Respiratory Pharmacist

Every year approximately 1400 people die from asthma in the UK, more than the number of deaths from asthma in Austria, Finland, Sweden, Poland and Portugal combined.

 Approximately 5.6 million people live with asthma in UK. Asthma symptoms and exacerbations have shown to impact significantly on people’s quality of life and activities of daily living affecting sleep and the ability to go to work or school or exercise.  Those with more severe disease live with the uncertainty of unplanned emergency visits to their GPs or hospital and for some a fear of death.

Why asthma kills  is the first and largest national enquiry into the circumstances surrounding asthma deaths, published today by the Royal College of Physicians.

So why are people still dying from asthma?

The majority of these deaths are preventable.

As the report highlights there is a degree of complacency about asthma, an illness that can and does kill. There is not enough attention paid to the importance of good asthma care and long term management of the condition by both clinicians and patients.

There is lack of education in recognising the symptoms of asthma deterioration, poor asthma control and what to do during an attack. Generally, the standard of care received was less than satisfactory in a quarter of those who died and there was “room for improvement” in the care received by 83%.

So what can we, pharmacists, do to improve the quality of care for asthma patients?

Pharmacists in community settings are in a strong position to offer additional support and advice to people with asthma who are coming in for their inhaler, help them manage their condition and spotting who may be in danger of an asthma attack. Good asthma care can prevent asthma attacks and save lives.
We know that incorrect use of inhalers is a big factor in poor asthma control so asking people to demonstrate how they use their inhaler should be part of an annual review and ideally their technique checked at every opportunity.

Nineteen per cent of those who died were smokers and others, including many children, were exposed to second-hand smoke in the home.  Smoking advice and smoking cessation services for asthma patients or careers should be offered at every opportunity by a pharmacist.

As a hospital pharmacist I do strongly support the recommendation that every hospital and GP practice should have a designated named clinician for asthma services and anyone who has been admitted to hospital or treated for an asthma exacerbation should be followed-up and reviewed as soon as possible. Primary care prescribing systems should generate alerts for people who are collecting too few preventer or too many relievers.  Adherence to medicine is a major concern in the management of asthma

There is a lot that should be done,its good news that the causes for asthma deaths are preventable in the majority of cases. I believe strongly that by working as a team healthcare professions can help improve the care we provide for patients with asthma significantly.