A number of evidence-based risk factors for poor outcomes in asthma have been identified. In 2014, the UK National Review of Asthma Deaths (NRAD) found widespread problems in the quality of care of individuals who died between 2011 and 2013. In the review of children, care was found to be below the expected standards in 46% of deaths.
In the NRAD, risk factors such as variations in care, excess short acting inhalers, insufficient controller prescription, failure to check inhaler technique and failure to issue personal asthma action plans or to perform annual reviews were identified.
Some of these risk factors have been known for nearly 50 years, and of 19 recommendations to reduce these, only one has been implemented to date. Sadly, the UK’s poor record of asthma care persists and there are continued examples of preventable asthma attacks and childhood asthma deaths.