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Time for action to stop needless asthma deaths

Asthma is not just an excuse to skip PE.

So says the charity Asthma UK on its website, highlighting the alarming complacency and lack of understanding that surrounds this condition. Sometimes viewed by outsiders as little more than an inconvenience, a bad attack of asthma can be life-threatening. Three people die in the UK every day because of it.

Failings in care have been implicated in many of those deaths. A hard-hitting new report by the highly respected Royal College of Physicians found major avoidable factors involved in two-thirds of the deaths it looked at between February 2012 and January 2013. Prescribing errors were implicated in nearly half of cases.

The report was commissioned specifically to look into why the UK's asthma death rate has failed to come down for many years. It was already known that many deaths were preventable but this report sheds light on exactly what is going wrong and its findings are truly shocking. It should be read by every health professional involved in asthma care, as well as every patient and their family.

The report points to a failure by doctors and patients to recognise the life-threatening warning signs of asthma. That such a common condition should be so poorly understood by those living with it and, above all, treating it is hard to credit. Patients are not being given enough information about managing their asthma and doctors are failing to spot the warning signs of patients who might be at risk of a potentially fatal attack. For instance, too many medics apparently fail to notice that they are repeatedly prescribing reliever inhalers (as opposed to preventative medication), a sign that the patient needs to be better managed.

The report is equally relevant in England, Wales and Scotland (where 368,000 people are receiving treatment for asthma, one-fifth of them children), having been commissioned on behalf of the Scottish Government as well as the Department of Health. Worryingly, it comes just months after the charity Asthma UK Scotland issued its own highly critical report, which found that poor medical care and a failure to follow guidelines were putting lives at risk. People with asthma are supposed to have a written action plan telling them what to do if their symptoms worsen, but the majority do not have one. The report's authors believe that three-quarters of the 5700 annual hospital admissions caused by serious asthma attacks could be prevented if people with asthma were properly managed and cared for.

Better education for patients so that they can identify the warning signs (the personalised asthma plans could help with that), regular patient reviews and an electronic surveillance system to alert GPs and pharmacists when a patient is using too much reliever medication, are all helpful suggestions to have emerged from the report but now is the time for action. Unlike so many issues relating to mortality rates, this one is fixable. Ministers and NHS boards must address it straight away, so that these tragic, needless, preventable deaths are brought to an end.

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Health

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