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Optimising Asthma Reviews

Estimated timings:
2-4 weeks to set up & run the project (steps 1-4)
2-3 months if including review (step 5)

Can be done by a GP, Pharmacist, Trainee or Student

Green Impact for Health Toolkit area: Prescribing & Quality Improvement

CQC Areas

  • Safe (Medicines Optimisation)
  • Effective (Delivering Evidence-Based Care and Treatment)
  • Caring (Independence, Choice and Control)
  • Well-Led (Environmental Sustainability)

On this page

The benefits of this project

Project benefits for Your Patients

Benefits for Your Patients

  • Improve asthma control leading to improved quality of life for patients with asthma
  • Reduce risk of asthma attacks
Project benefits for Your Practice

Benefits for Your Practice

  • Reduce workload from unscheduled care related to poorly controlled asthma
  • Upskill whole team to be able to provide evidence-based asthma care
Project benefits for The Planet

Benefits for The Planet

  • Well controlled asthma has 1/3rd of the carbon footprint of poorly controlled asthma

Opportunity for improvement

  • Important: This is a quality improvement resource only and not clinical guidance. Users must follow local and national guidelines and review disclaimers and carbon footprint methodology before starting. Clinical responsibility lies with the user.
  • This project outlines how to optimise asthma reviews in your practice and empower patients.
  • Sub-optimally controlled asthma is common, in part because of normalisation of symptoms, underuse of preventer therapy, overuse of reliever therapy, and poor inhaler technique.
  • Asthma reviews are an essential opportunity for reviewing if patients are using the right inhaled medicine and if this is getting to the right place in the airways.
  • Empowering patients to understand their condition and how to manage it is an important element in improving asthma outcomes.
  • You might like to create a SMART goal for your projects such as: Improving the invites sent for asthma reviews within 2 weeks; holding an education session for clinical team members using educational videos within 1 month.

How to carry out this project

  1. Review the information sent in an asthma review invite

    ow are patients invited to an asthma review?

    Is it with text message, letter, or booking link?

    Is there any opportunity to link this process with some patient educational information or questionnaires to guide the review?

  2. Update your asthma review invites

    Consider including:

    • Importance of the review
    • What to bring (inhalers, personalised asthma action plan, peak flow meter)
    • Information leaflet or video on SABA over-reliance
    • Information about inhalers and the environment
    • Asthma control test questionnaire for patients to complete prior to their review

    Resource: Example Text Invite

    SMS 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: https://www.asthma.org.uk/advice/manage-your-asthma/adult-review/ Before your asthma review, you can also learn more about asthma treatment from this leaflet https://bit.ly/4mT5DPn or watch this video https://bit.ly/3TiNoVL. To learn more about types of inhaler devices for people with asthma please read this leaflet bit.ly/3HDtxyc or watch this video https://bit.ly/4n36EEC.

  3. Letter template

    Resource: Letter invite to asthma review

    Dear Patient, 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 more than two salbutamol (blue) inhalers a year, this could mean your asthma control needs improvement? This Asthma + Lung webpage explains how to get the most out of your review: https://www.asthma.org.uk/advice/manage-your-asthma/adult-review/ Before your asthma review, you can also learn more about asthma treatment from this leaflet https://bit.ly/4mT5DPn or watch this video https://bit.ly/3TiNoVL. To learn more about types of inhaler devices for people with asthma please read this leaflet bit.ly/3HDtxyc or watch this video https://bit.ly/4n36EEC. 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]

  4. Clinical update session

    Organise a clinical update session to optimise asthma reviews. Invite all clinical staff who undertake asthma reviews.

    Watch the educational videos on improving asthma reviews and explaining asthma to patients. You may also wish to look how other resources may support asthma reviews such as the visual aid for optimising asthma reviews and the asthma airways diagram.

    You may wish to discuss which asthma template people find most useful for conducting a review.

    Using placebo devices: Discuss and practice inhaler technique for the commonly used inhalers or those in your local guidance. Our project on optimising inhaler device choice in asthma would be useful to do alongside this project.

    Discuss non-pharmacological elements of asthma management. You may wish to show the patient resources available on the asthma and lung UK website:

    • Very brief advice on smoking
    • Understanding the link between air pollution and asthma symptoms can help people to manage their asthma. We have a separate project on this.
    • Staying active, breathing exercises and singing regularly as part of a group can reduce asthma symptoms and improve general health and wellbeing.

  5. Re-audit

    Review this project after 2-3 months, summarise learning, share with practice team + decide if any changes are needed to improve the process.

    Use the Project Monitoring form to keep track of the project and when to re-run.

Top tips

Watch the videos on improving asthma reviews and explaining asthma to patients on the asthma toolkit page.

Create links to our patients leaflets and videos in your asthma invites or AccuRx messages.

How to scale this project up or down

Please note - Use of this project requires NetworkPLUS membership. If you would like to share this project with others, please invite them to purchase their own membership—access must not be shared with non-members.

You could upscale this project by taking it to your PCN pharmacy team to implement across all practices in your PCN. 

Have you completed this QIP?

Tell us a little about your project in order to generate a certificate showing the probable benefits. This project may help with CQC evidence submission (see disclaimers).

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