Cargando…

A review of asthma care in 50 general practices in Bedfordshire, United Kingdom

The United Kingdom (UK) National Review of Asthma Deaths (NRAD) (2011–2014) identified a number of contributory risk factors which had not previously been recognized by those caring for people with asthma. Only one of the 19 NRAD recommendations has so far been implemented nationally, and that only...

Descripción completa

Detalles Bibliográficos
Autores principales: Levy, Mark L, Garnett, Fiona, Kuku, Adedayo, Pertsovskaya, Inna, McKnight, Eddie, Haughney, John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6062519/
https://www.ncbi.nlm.nih.gov/pubmed/30050083
http://dx.doi.org/10.1038/s41533-018-0093-7
_version_ 1783342385167597568
author Levy, Mark L
Garnett, Fiona
Kuku, Adedayo
Pertsovskaya, Inna
McKnight, Eddie
Haughney, John
author_facet Levy, Mark L
Garnett, Fiona
Kuku, Adedayo
Pertsovskaya, Inna
McKnight, Eddie
Haughney, John
author_sort Levy, Mark L
collection PubMed
description The United Kingdom (UK) National Review of Asthma Deaths (NRAD) (2011–2014) identified a number of contributory risk factors which had not previously been recognized by those caring for people with asthma. Only one of the 19 NRAD recommendations has so far been implemented nationally, and that only partially, and as yet systems are not in place to identify patients at risk of attacks and dying from asthma. In 2015/2016 Bedfordshire Clinical Commissioning Group (CCG) in England, UK, initiated a quality asthma audit of people with asthma to identify some of the risk factors identified in the NRAD report with the aim of optimizing patient care. Fifty (89%) of the General Practices caring for 415,152 patients (27,587 diagnosed with asthma (prevalence 7%; range 4–12%)), participated and the results identified a wide variation in process of care and presence of risk factors including: excess short acting reliever and insufficient preventer prescriptions, failure to issue personal asthma action plans, and to perform annual reviews or check inhaler technique. Identification of these patients involved high-intensity input by trained asthma nurses using sophisticated data extraction software. GP computer systems used in primary care currently do not have the functionally, without the need for manual audit, to implement the NRAD recommendations, starting with the identification of patients at risk. Modifications to existing systems within both primary and secondary care are required in order to prevent unnecessary deaths related to asthma. There is a pressing need to move towards a more pro-active model of care.
format Online
Article
Text
id pubmed-6062519
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Nature Publishing Group UK
record_format MEDLINE/PubMed
spelling pubmed-60625192018-07-30 A review of asthma care in 50 general practices in Bedfordshire, United Kingdom Levy, Mark L Garnett, Fiona Kuku, Adedayo Pertsovskaya, Inna McKnight, Eddie Haughney, John NPJ Prim Care Respir Med Article The United Kingdom (UK) National Review of Asthma Deaths (NRAD) (2011–2014) identified a number of contributory risk factors which had not previously been recognized by those caring for people with asthma. Only one of the 19 NRAD recommendations has so far been implemented nationally, and that only partially, and as yet systems are not in place to identify patients at risk of attacks and dying from asthma. In 2015/2016 Bedfordshire Clinical Commissioning Group (CCG) in England, UK, initiated a quality asthma audit of people with asthma to identify some of the risk factors identified in the NRAD report with the aim of optimizing patient care. Fifty (89%) of the General Practices caring for 415,152 patients (27,587 diagnosed with asthma (prevalence 7%; range 4–12%)), participated and the results identified a wide variation in process of care and presence of risk factors including: excess short acting reliever and insufficient preventer prescriptions, failure to issue personal asthma action plans, and to perform annual reviews or check inhaler technique. Identification of these patients involved high-intensity input by trained asthma nurses using sophisticated data extraction software. GP computer systems used in primary care currently do not have the functionally, without the need for manual audit, to implement the NRAD recommendations, starting with the identification of patients at risk. Modifications to existing systems within both primary and secondary care are required in order to prevent unnecessary deaths related to asthma. There is a pressing need to move towards a more pro-active model of care. Nature Publishing Group UK 2018-07-26 /pmc/articles/PMC6062519/ /pubmed/30050083 http://dx.doi.org/10.1038/s41533-018-0093-7 Text en © The Author(s) 2018 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Levy, Mark L
Garnett, Fiona
Kuku, Adedayo
Pertsovskaya, Inna
McKnight, Eddie
Haughney, John
A review of asthma care in 50 general practices in Bedfordshire, United Kingdom
title A review of asthma care in 50 general practices in Bedfordshire, United Kingdom
title_full A review of asthma care in 50 general practices in Bedfordshire, United Kingdom
title_fullStr A review of asthma care in 50 general practices in Bedfordshire, United Kingdom
title_full_unstemmed A review of asthma care in 50 general practices in Bedfordshire, United Kingdom
title_short A review of asthma care in 50 general practices in Bedfordshire, United Kingdom
title_sort review of asthma care in 50 general practices in bedfordshire, united kingdom
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6062519/
https://www.ncbi.nlm.nih.gov/pubmed/30050083
http://dx.doi.org/10.1038/s41533-018-0093-7
work_keys_str_mv AT levymarkl areviewofasthmacarein50generalpracticesinbedfordshireunitedkingdom
AT garnettfiona areviewofasthmacarein50generalpracticesinbedfordshireunitedkingdom
AT kukuadedayo areviewofasthmacarein50generalpracticesinbedfordshireunitedkingdom
AT pertsovskayainna areviewofasthmacarein50generalpracticesinbedfordshireunitedkingdom
AT mcknighteddie areviewofasthmacarein50generalpracticesinbedfordshireunitedkingdom
AT haughneyjohn areviewofasthmacarein50generalpracticesinbedfordshireunitedkingdom
AT levymarkl reviewofasthmacarein50generalpracticesinbedfordshireunitedkingdom
AT garnettfiona reviewofasthmacarein50generalpracticesinbedfordshireunitedkingdom
AT kukuadedayo reviewofasthmacarein50generalpracticesinbedfordshireunitedkingdom
AT pertsovskayainna reviewofasthmacarein50generalpracticesinbedfordshireunitedkingdom
AT mcknighteddie reviewofasthmacarein50generalpracticesinbedfordshireunitedkingdom
AT haughneyjohn reviewofasthmacarein50generalpracticesinbedfordshireunitedkingdom