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The UK's primary care sustainability network

4. Identifying poor control at medication review

Routine medication review offers opportunities for identifying patients who are at risk of poor control. 

The process

Step 1: Identify which staff take prescription requests and which conduct medication reviews

This may be receptionists, nurses, pharmacists or doctors.

Step 2: Show staff how to check inhaler prescriptions

The Primary Care IT guide shows how to check SABA use, ICS prescriptions and oral prednisolone use. It can be taught in a brief training session and then kept accessible for reference. Staff should check for SABA over-reliance and ICS use during the medication review.


Step 3: Review asthma management

If evidence of any of the following:

  • SABA over-reliance (6 or more SABA in 12m)
  • Underuse of preventer inhaler (Less than 3 ICS inhalers in 12m)
  • Asthma exacerbations (hospital attendance or oral prednisolone use)

Then either review asthma medication at the time or arrange for a follow-up asthma review.



SMS templates

Invitation for patients with SABA over-reliance

It looks like you have needed 6 or more blue inhalers in the past year – this may mean that your asthma treatment needs improving. Please book an asthma review.

AccuRx SMS
It looks like you have needed 6 or more reliever (blue) inhalers in the past year – this may mean that your asthma treatment needs reviewing. Please book an asthma review.
To learn more, please see here

Letter templates

Consultation invite for patients at risk of poor control

Dear Patient,

Our records show that your asthma may not be well controlled. This may be because you have had an asthma attack or exacerbation recently, or because you are needing more or less than the recommended amount of medication. Please call to book an asthma review appointment as soon as possible.

Asthma reviews are essential to help ensure you’re on the right treatment. Being on the right treatment should reduce your symptoms and lower your risk of future asthma attack. 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]