Asthma Inhaler Prescription Warning


Tens of thousands of people are at risk of potentially life-threatening asthma attacks because they are not being correctly prescribed inhalers, a charity has warned.

Asthma UK said more than 22,000 people with asthma in the UK - including 2,000 children - have been incorrectly prescribed long-acting reliever inhalers, which carry a black box warning in the United States because they are unsafe if not used appropriately.

Its analysis, which is based on data from more than 500 UK GP practices, also found that almost 100,000 people with asthma have been prescribed too many short-acting reliever inhalers (more than 12 in a year) without national clinical guidelines being followed, which are also leaving them at risk.

The charity said it is dangerous to use a long-acting reliever inhaler alone, without a steroid preventer inhaler or as a combination inhaler as, although it helps to keep the airways open, it does not treat the underlying inflammation.

This leaves the airways inflamed and is more likely to react to triggers such as pollen or pollution, putting them at risk of having a potentially life-threatening asthma attack.

The charity said that patients should check if they are using an inhaler which has Salmeterol, Formoterol or Tiotropium bromide as the only active ingredient. If they are taking this without a steroid preventer inhaler as well, then they should contact their GP right away.

Meanwhile if someone with asthma is prescribed more than 12 short acting reliever inhalers in a year (thus using it more than three times a week) without seeing a doctor, it is a key indicator they are not managing their condition and that their treatment needs reviewing, the charity said.

It added that although asthmatics should not worry as they are not in any immediate danger, it is important they really understand their medicines and take an active role in managing their condition.

The UK has some of the worst asthma mortality rates in Western Europe, with children four times more likely to die from an asthma attack than children in Germany, Spain, Finland, Portugal or Sweden.

Someone has a potentially life-threatening asthma attack every 10 seconds in the UK, and more than 1,200 people die as a result of this every year.

The charity said that despite it being one of the most common long-term conditions among adults, and the most common among children, many of the one in 11 people with it fail to receive the right medication.

Asthma UK chief executive Kay Boycott said: "It is simply unacceptable that the lives of people with asthma are being put at risk because of unsafe prescribing.

"The UK has some of the highest mortality rates for asthma in Western Europe and the levels of unsafe prescribing identified in our report today must be stopped.

"It is crucial that healthcare professionals review their systems and urgently recall patients who have been prescribed long-acting reliever inhalers on their own without a steroid preventer, or not as a combination inhaler.

"NHS bodies must ensure systems are in place to stop unsafe asthma prescribing from happening and implement all the recommendations from the National Review Of Asthma Deaths to improve patient safety and end complacency in asthma care."

Dr Mark Levy, GP and author of the National Review Of Asthma Deaths, which last year highlighted prescribing errors in nearly half of asthma deaths in primary care, said: "Asthma UK's report is welcome as it echoes the findings from the National Review Of Asthma Deaths.

"There is widespread failure to recognise risk of attacks and therefore asthma death. Yet the reality is that deaths can be prevented when symptoms are managed effectively, with safe use of asthma medicines and in partnership with the patient."

Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing, said: "It is worrying that many people with asthma are still being treated in outdated and potentially very dangerous ways.

"Because asthma is relatively common, many people do overlook the seriousness of the condition, and can be unaware of available effective preventative treatments.

"Nurses and pharmacists teach inhaler technique and should receive training in it to ensure that people are supported to take their medications effectively."

Matthew Hodson, chairman of the Association of Respiratory Nurse Specialists, said: "This report sadly highlights continuing concerns, a year on from the national review, that patients with asthma may not always be receiving the best evidence based care in terms of the drugs they are prescribed and how they are used.

"Correct training is crucial and should encompass the correct diagnosis, the understanding of asthma guidelines in practice, and the best evidence for long term treatment.

"Respiratory nurses have a role to support this but so much of asthma care is undertaken in primary care that all staff have a responsibility to ensure evidence-based care is followed and all employers should ensure that staff can access asthma training."

Professor Russell Viner, officer for health promotion at the Royal College of Paediatrics and Child Health, said: "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."

Before You Go