Asthma patients ‘dying needlessly’

Three people die from asthma every day in the UK, while someone suffers from a potentially life-threatening attack every 10 seconds. But experts from the Royal College of Physicians (RCP) said a large number of deaths caused by asthma could have been prevented.

A report by the RCP found that that patients are not receiving adequate advice and information on managing their asthma, and that medics are failing to spot key signs which indicate patients are not managing their condition well.

Physicians examined 195 asthma deaths, including 28 children, and identified at least one “major potential avoidable factor” in 67 per cent of the cases.

GP Dr Mark Levy, RCP’s clinical lead for the report, said: “It is very sad that people are not aware that asthma can kill. Doctors, patients and their families failed to recognise life-threatening danger signs of asthma. We identified major avoidable factors in two-thirds of the people who died.”

This confidential enquiry has identified prescribing errors of a frankly horrifying scale and is a damning indictment of current routine practice Kay Boycott

The review found that many of the patients who died had excessively used their reliever inhalers in the months running up to their deaths – indicating that they were not managing their disease well.

The report is timed to coincide with World Asthma Day, and and sets out a series of recommendations for health workers, including an electronic surveillance system so doctors know automatically when patients are excessively using their reliever medication.

‘Complacency’

The report’s authors said that medics should have spotted that they were repeatedly prescribing these inhalers and taken action.

Meanwhile one in 10 of those who died had been admitted to hospital for an acute asthma attack within four weeks of their death. The report also found that 45 per cent of those people who died following an asthma failed to call for help or obtain help during their attack and the vast majority of children died even before they reached hospital.

Dr Levy said: “It might be that in these cases people were complacent about their asthma and we feel that the majority of these people did not know what to do – they did not recognise the danger signs they did not know how or when to call for help.”

He said that three quarters of those who died did not have a personalised asthma plan which would have provided them with this information.

Of those who died, half were being treated for mild or moderate asthma at the time, indicating that neither the patient, nor their doctor, realised how serious their case was.

Professor Mike Morgan, NHS England’s national clinical director for respiratory services, said: “These statistics are a call to action for commissioners, health professionals and patients.

‘A damning indictment of current routine practice’

The charity Asthma UK said that prescribing errors were detected in 47 per cent of the deaths studied, and said it was “shocking” that experts identified “room for improvement” in 83 per cent of the cases.

Kay Boycott, chief executive of the charity, said: “This confidential enquiry has identified prescribing errors of a frankly horrifying scale and is a damning indictment of current routine practice… Parents of children with asthma will be especially horrified that the confidential enquiry showed that children fared worse than adults in multiple aspects of care, and fell well below expected standards in almost half of child deaths.

“Above all, we need leadership at every tier of the health system across the UK to challenge the complacency about asthma and prevent life threatening asthma attacks.”