Caroline Fredericks: How nurses can help cut asthma death rate 

On World Asthma Day, 1 May, nurse specialist Caroline Fredericks of Asthma UK explains what asthma nurses can do to lead the way in preventing asthma deaths

On World Asthma Day, 1 May, nurse specialist Caroline Fredericks of Asthma UK explains what asthma nurses can do to lead the way in preventing asthma deaths

Discussing an asthma care plan. Picture: Charles Milligan

Research by charity Asthma UK reveals that the UK is among the worst countries in Europe for asthma death rates, falling behind countries including France, Germany and the Netherlands.

More than two-thirds of patients lack basic asthma care, and this could be part of the problem.

As a specialist nurse on Asthma UK’s telephone helpline, I speak to people every day who are struggling to manage their asthma. Some are having asthma attacks when they call.

The advice we give without fail is to make sure they are getting basic care from their GP or asthma nurse, including a written asthma action plan, a yearly asthma review and an inhaler technique check.

Role of practice nurses

Practice nurses can play a central role in ensuring the 5.4 million people with asthma in the UK are receiving good basic care, but this can be difficult with only short appointment times in clinics.

What can we do to help make sure people are getting the tools they need to manage their asthma?

Encouraging patients to attend an asthma review appointment at least once a year gives you and your patient the opportunity to make sure they are getting the right treatment.

As well as assessing someone’s asthma control, it’s important to get some context about their symptoms. Have they worsened? Have they noticed any pattern when this happens?

Some telltale signs

There are also telltale signs that someone’s asthma is not under control. Are they having to use their reliever inhaler more than three times a week? Are they waking up during the night coughing? Making your patient aware of these warning signs could help them become more aware of patterns in their symptoms in the future.

Listening to your patient is key: when they talk about how asthma affects their day-to-day life you can pick up clues on how their condition is being managed.

Help patients identify their specific asthma triggers, whether it’s cold air, pollen or animals. Encourage them to keep a symptom diary or record a video on their smartphone of any flare-ups. Anything that adds detail and helps them to better understand any patterns will help reduce their risk of an asthma attack.

An action plan is vital

Medical guidelines say a written action plan is a key part of self-management as it includes all the information a patient needs in order to be able to look after their asthma. It can help them monitor their asthma and pinpoint signs that it’s getting worse, so they can seek help and cut their risk of an asthma attack.

It also helps them understand when and how to take their medication so as to keep their asthma under control. Evidence shows that patients who use written asthma action plans are four times less likely to be admitted to hospital because of their asthma.

It doesn’t take long to discuss and write up an action plan. You can download an action plan template for your patient free from the Asthma UK website.

Incorrect inhaler use

Asthma UK’s research revealed that 66% of people with asthma are not using a written asthma action plan, so it is essential that we keep promoting them in clinics.

On the Asthma UK telephone helpline I hear from many people who aren’t sure of the best way to take their medication, and the survey showed that up to a third of people with asthma aren’t using their inhaler correctly. That’s why checking your patient’s inhaler technique at their asthma review is so important.

Help them to understand that using their inhaler correctly with a spacer helps to deliver the right amount of medicine into their lungs, making it more effective and giving them a better chance of staying well.

Working together

If they’ve been prescribed a new device, take the time to explain how it works and check that they know how to use it correctly. Patients should also be replacing their spacer at least once a year.

As nurses, having an open dialogue with our patients is essential to ensure they are managing their condition as well as possible. A written asthma action plan, coming to the surgery every year for an asthma review and ensuring their inhaler technique is checked are all vital in ensuring patients stay well.

If all of our patients are receiving the best basic care, we can work together to reduce their chances of a fatal asthma attack and help cut asthma death rates in the UK.

Caroline Fredericks is an Asthma UK telephone helpline nurse 



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