82% of asthma hospitalisations not getting recommended two-day follow-up

Epidemiological study shows significant numbers of asthma patients not receiving standard level of care, and worse for black patients

A woman with short grey hair and purple jumper using an asthma inhaler and spacer

Asthma patients who ended up in hospital only had a GP appointment within recommended 48-hour period in 18% of cases between 2017-19, new research shows.

New data published in the British Journal of General Practice looked at electronic healthcare records from more than 17,000 patients over the age of five. As well as falling far below the recommended primary care appointment 48 hours after a hospital visit following an asthma episode, the records also show that only 60% of patients had a follow up appointment within a 28-day period.

Dr Shamil Haroon from the Institute of Applied Health Research at the University of Birmingham and senior author of the study said:

“This analysis shows that a significant proportion of people who need hospital care following an asthma attack aren’t getting the expected standard of follow up care. Of particular concern is that there is serious inequality in the care received by some patients including black patients.

“Not only are most patients not getting care in the recommended timeframe of 48 hours, but patients are being left for months and more before being reviewed. We recommend that robust plans be put in place to ensure that these recommendations are being followed more closely, and greater scrutiny where they are not.”

....a significant proportion of people who need hospital care following an asthma attack aren’t getting the expected standard of follow up care.

Dr Shamil Haroon

Dr Prasad Nagakumar from Birmingham Children’s Hospital and senior author of the study said:

“Black patients whose records were included in the study were found to receive less care associated with asthma management. We estimate that depending on their age, black patients were between 27% and 54% less likely to receive the level of care that white peers were provided.

“Our study highlights significant shortfalls in implementing the recommendations of the 2014 national review of asthma deaths for follow up of hospitalised asthma patients. It is time for policy makers to review the recommendations to reduce the health inequalities experienced by black and ethnic minority groups who also have a high risk of fatal and near fatal asthma attacks.”

Further evidence suggests that while most patients received medication (57% of all patients) following an appointment, few patients were offered asthma reviews (13%) or management plans (8%), and only 1% of smokers were offered cessation counselling.

The study was funded by a NIHR- WM innovation grant.

Notes for editors

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  • The University of Birmingham is a founding member of Birmingham Health Partners (BHP), a strategic alliance which transcends organisational boundaries to rapidly translate healthcare research findings into new diagnostics, drugs and devices for patients. Birmingham Health Partners is a strategic alliance between seven organisations who collaborate to bring healthcare innovations through to clinical application:
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    • Birmingham Women's and Children's Hospitals NHS Foundation Trust
    • Aston University
    • The Royal Orthopaedic Hospital NHS Foundation Trust
    • Sandwell and West Birmingham Hospitals NHS Trust
    • West Midlands Academic Health Science Network
    • Birmingham and Solihull Mental Health NHS Foundation Trust


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