Asthma - 23,000 sufferers could be on the wrong medication

Asthma Inhaler

A report from Asthma UK has found that wrongly-prescribed and incorrectly administered drugs could be contributing to asthma deaths.

The Royal College of Physicians published a report last year detailing the results from an analysis of 195 deaths attributed to the condition. This investigation uncovered two common irregularities: longer-acting reliever medication was being issued without an accompanying steroid inhaler and short-term reliever inhalers were being prescribed too often.

Asthma UK has since looked at how widespread these errors were, examining information from almost 95,000 asthma patients from across 500 UK GP practices, which identified a probable 402 individuals who were prescribed longer-acting inhalers without a steroid inhaler. The report authors describe this practice as "unsafe, unlicensed and puts the lives of patients at risk".

While the majority of known sufferers have access to asthma clinics at their GP surgery, infrequent monitoring could lead to poor management of the condition, which can lead to the condition spiralling out of control.

While stressing that sufferers are not in any immediate danger, Asthma UK advises that people review which medication they are using and how often, checking in with their GP if they spot any cause for concern.

How much is too much?

Requiring more than six reliever inhalers per year indicates poor asthma control while anybody who requires 12 or more of the blue short-acting or reliever inhalers per year should see their GP as this means the condition is not being properly controlled and other drugs may be needed.

Asthma UK also advises anyone who uses their blue inhaler more than three times per week to arrange a review with a medical professional.

Worryingly, Asthma UK's review found that 5,032 people had been prescribed more than 12 reliever inhalers within a 12 month period, 1,965 of them without being reviewed, including 117 children. This could potentially mean a total of 107,000 people with asthma, 10,000 of which are aged under 15, could be being prescribed excessive amounts of reliever medication without being properly reviewed.

Professor Russell Viner, officer for health promotion at the Royal College of Paediatrics and Child Health, told the BBC: "The UK has one of the highest rates of asthma prevalence, hospital admissions and mortality in the world. Whilst asthma can be a serious condition, children can live with it and lead a normal life, providing it is managed correctly. A huge part of this is making sure we intervene early and ensure preventative medication is given as well as used to relieve symptoms in emergencies... up to 2,000 children have been prescribed medicines not licensed for use in asthma. This means not only will it fail to treat the underlying cause but it puts these children at increased risk of death.

He added: "Partnership working is something that must also be coordinated across primary care and hospitals using new clinical pathways to ensure we give young people with asthma the best joined-up care. And finally, children with asthma must be trained in good inhaler technique to ensure they are able to take their medicine correctly and receive the right dosage."

The Medicines and Healthcare Products Regulatory Agency (MHRA) has said that a bulletin has been published with updated guidance for prescribers and patients. However, this information is likely to take some time to filter through to all staff and patients.

What causes asthma?

There are many causes of asthma, and these can vary from person to person.

According to Asthma UK, research has shown that you are more likely to develop asthma if:

  • you have a family history of asthma, eczema or any allergies – for example, evidence shows that if one or both of your parents have asthma, you are more likely to have it.
  • you have eczema or an allergy, such as hay fever (an allergy to pollen)
  • you had bronchiolitis (a common childhood lung infection) as a child
  • you were born prematurely, especially if you needed a ventilator to help you breathe after birth
  • your birth weight was low because you didn’t grow at a normal rate in the womb
  • your mother smoked during pregnancy – research has shown that smoking during pregnancy significantly increases the risk of a child developing asthma
  • your parents smoke or smoked around you when you were a child
  • you regularly spend time around those who smoke – research shows that being exposed to second-hand cigarette smoke means you’re more likely to develop asthma
  • you have been exposed to certain substances at work - this is known as occupational asthma
  • you’re an adult female – hormones can affect asthma symptoms, and some women first develop asthma before and after the menopause.

Asthma UK, facts and figures

  • 5.4 million people in the UK are currently receiving treatment for asthma: 1.1 million children (1 in 11) and 4.3 million adults (1 in 12).
  • Asthma prevalence is thought to have plateaued since the late 1990s, although the UK still has some of the highest rates in Europe and on average three people a day die from asthma.
  • There were 1,167 deaths from asthma in the UK in 2011 (18 of these were children aged 14 and under)
  • An estimated 75% of hospital admissions for asthma are avoidable and as many as 90% of the deaths from asthma are considered preventable.

Why do so many suffer with asthma?

It is thought that changes to how we live and work coupled with other lifestyle choices could be contributing to a rise in diagnosis.

For example, many of us now live in a much more hygienic environment than we used to - one area of current research is that these improved living conditions may have reduced childhood infections, which can mean the immune system does not develop as efficiently. Pollution, traffic and industrial fumes could also play a part in causing some to develop the condition.

For those that have asthma, an attack can be triggered by various things including strenuous exercise, house dust, pollen, moving from a warm room into the cold air or cigarette smoke.

For more information about causes, triggers, diagnosis and treatment of asthma and for information packs and helpline details, visit the Asthma UK website.

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Georgie Fenn, writes most of our news articles and social media posts.