World Asthma Day
Are you doing all you can to support patients with asthma? A report from the Royal College of Physicians in the UK, released on World Asthma Day (6 May), suggests that pharmacists could be doing much more. Researchers explored the individual circumstances of people who had died of asthma in a 12-month period from February 2012, to try to understand why the number of asthma deaths in the UK (around 1,200 a year) had not reduced, even though it is believed that there are preventable factors in 90% of deaths.
The Table lists some of the findings of the report, and what solutions pharmacists could offer to improve outcomes for asthma patients.
What pharmacists can do
In cases with a primary care asthma review recorded, 29% had no recorded assessment of inhaler technique
Check patients’ inhaler technique
Where there were prescribing data (n=165) 39% of patients had been prescribed more than 12 short-acting beta agonist (SABA) inhalers in the year before they died and 4% had been prescribed more than 50 SABA inhalers in the same period
Look out for excessive use of SABA inhalers
Of those who died (n=128), 38% had been issued with fewer than four inhaled corticosteroid inhalers in the previous year
Monitor and support adherence to inhaled corticosteroid therapy
22% of patients had missed a routine asthma appointment in the year before they died
Liaise with doctors to ask which patients have missed an asthma review and offer a review in the pharmacy
Only 23% of patients had a record of having been provided with a personal asthma action plan
Ensure patients have a personal asthma plan and that they understand it
33% of patients who died had no record of seeking medical assistance during their final asthma attack
Educate patients on asthma, particularly when to seek medical attention
Of those who died, 19% were smokers
Support patients to stop smoking
56% of those who died were overweight and 31% were obese
Give advice on weight loss
According to the report, in a quarter of those who had died, the standard of care received was less than satisfactory. Moreover, at least half of those who died were being treated for mild or moderate asthma. The researchers claim that both clinicians and patients have become complacent about asthma, and their message is that even mild asthma can kill.
"These findings may well be mirrored in other countries and are a good reason for pharmacists to strengthen the care they give, as well as providing strong points to present to service commissioners and policy makers," says Luc Besançon, general secretary and CEO of FIP.
FIP recognises the valuable role of pharmacists in asthma care, most recently organising a session on this common condition at its congress in Dublin last year. In addition, members have access to a number of resources giving examples of asthma services offered by pharmacists around the world (contact email@example.com). Asthma is also highlighted by FIP in its statement of policy on the role of the pharmacist in the prevention and treatment of chronic disease.
Our support for pharmacy input into asthma continues at the World Pharmacy Congress in Bangkok this year, where you can learn how colleagues in Belgium are helping patients manage this long-term condition through a new service. The first registration deadline is fast approaching: sign up for the congress before 15 May to take advantage of the early bird fee.
We encourage you to take a few minutes today to reflect on the care you provide to asthma patients and think about what more you could be doing to prevent unnecessary deaths.
The full report “Why asthma kills” is available here.