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The UK's primary care sustainability network

3. Optimising asthma reviews & patient self-management

Asthma reviews are an essential opportunity to assess patients’ disease control and optimise it. You may wish to first focus on the highest risk patients identified from disease control project 1. This will ensure that the highest need patients are prioritised for review and will also enable you to meet the IIF incentives RESP-01 and RESP-02 that are about reducing SABA over-reliance and underuse of preventer inhalers. 

When inviting patients for their asthma review, consider sending them resources within the invite to enable patients to think about their disease control and decide what they want to discuss or learn at their review.

Primary Care IT have developed an asthma review template for use with this toolkit, which can be added to your clinical system to optimise your asthma reviews. It pulls important information regarding asthma control from the clinical record, has prompts to support your discussion with patients and includes links to information about lower carbon prescribing.

The process

Step 1: Update your Asthma Review invitations

Update your SMS templates and letters to include links to information on:

  • Importance of review and what to bring (PAAP, inhalers, peak flow meter)
  • Links to Patient Information Leaflet or patient videos on SABA over-reliance, inhaler choice and disposal to prime patients.


Step 2: Consider which Asthma Review Template you wish to use in your clinical system

This Asthma Review Template from Primary Care IT will highlight whether the patient is at risk of poor control and support greener inhaler prescribing. If considered helpful, download the template onto the IT system (System One or EMIS). Provide brief education to staff who perform asthma reviews about how to use the template.


Step 3: Conduct Asthma Review Consultation with patient

Use our guide to support this.

Remember to discuss non-pharmacological asthma management such as the importance of smoking cessation, impact of air pollution, benefits of exercise, green walking routes and singing for breathing etc.


Non-pharmacological management resources

Local environment, pollution and housing can have a huge impact on asthma control and thinking about these could help you find non-pharmacological strategies that patients may be able to manage their asthma.

You can use the following resources to signpost patients towards options and these could be added to a pre-written text message on your service of choice e.g. AccuRx. You may also find further information on your local authority website, or through social prescribing or other health initiatives.

Singing for breathing

Singing regularly as part of a group can reduce asthma symptoms and improve general health and wellbeing. Groups are available all over the country and are suitable for people even with no experience of singing.


Air Pollution

Understanding the link between air pollution and asthma symptoms can help people to manage their asthma, both by modifying their activity to reduce air pollution locally and by knowing what action to take when air pollution is high.

Clean Air Hub have a pollution forecast, which is also available from Defra, and a knowledge hub for clinicians with resources to share with patients.

The Clean Air Route Finder can be used in London to find low air pollution routes.


London specific:

Living with asthma

The Asthma UK has lots of information on strategies for living with asthma, including how to get and stay active.


Indoor environment

The indoor environment can have a significant impact on asthma symptoms and Asthma UK has lots of advice on identifying and minimising triggers.


Other resources

Letter templates

Consultation invitation for asthma review with information-sharing

Dear Patient,

Our records show that you are due for an asthma review. Please call to book your asthma review appointment.

Asthma reviews are essential to ensure you’re on the right treatment, to reduce your symptoms and to lower your risk of asthma attacks. Many people don’t realise their asthma could be better controlled. Did you know that good asthma control means you will rarely or never have symptoms? Or that if you need three or more reliever (blue) inhalers a year, this could mean your asthma control needs improvement?

This website explains how to get the most out of your review:

For more information about your asthma, please see here and for information about inhalers and the environment, please see here.

We look forward to seeing you soon for your asthma review. Please remember to bring these things to your appointment: your inhalers and spacer, your Personalised Asthma Action Plan and your peak flow meter.

Many thanks,

[Practice name/ lead clinician]

SMS templates

Consultation invitation for asthma review with information-sharing

SMS 1 of 3
Your asthma review is due so please book an appointment. Remember to bring: your inhalers and spacer, peak flow meter and your Personalised Asthma Action Plan.

SMS 2 of 3
For more information on how to get the most out of your asthma review:

SMS 3 of 3
To learn more about asthma, inhalers and the environment before your asthma review, have a look here

AccuRx SMS 1 of 2
Your asthma review is now due so please book an appointment. Remember to bring: your inhalers and spacer, peak flow meter and your Personalised Asthma Action Plan.
This page explains how to get the most out of your review:

AccuRx SMS 2 of 2
Before your asthma review, you can also learn more about asthma treatment here
Did you know some inhalers are better for the environment? Find out more: Inhalers and the environment