Tuesday, 6 May 2014

Why Asthma Still Kills - Review of Deaths From Asthma

Today is World Asthma Day so it is appropriate that we talk about the recent publication 'The National Review of Asthma Deaths' (NRAB): Why Asthma Still Kills.

It has been noted that the number of deaths due to asthma in the UK has been standing at around 1200 for many years, even though the cause of death is usually preventable (in 90% of cases). Why should this be? We can prevent these deaths so why are we not preventing them?

NRAB spent a year (2012) interviewing all those involved in each asthma death (including parents, carers) in an attempt to learn more about the circumstances of each death and to identify commonalities.

NRAB is an extensive report looking at most factors involved in these deaths and its conclusions largely blame lack of awareness/lack of understanding/complacency by many people involved in the care of asthmatics people about the dangers of severe asthma - medical professionals and patients & carers - has a major influence on deaths by asthma. People (all people) are failing to take appropriate action because they don't realise how life threatening an attack can be until it is too late.

Why asthma still kills, the report of the National Review of Asthma Deaths was published on 6 May 2014 to coincide with World Asthma Day. The report and recommendations are available to download here.

Quoting from the Royal College of Physicians:
There are messages for doctors, nurses, patients, parents and carers in the findings and recommendations of the report. Deficiencies were found in routine asthma care and the review outlines recommendations to be taken forward by not only those who treat patients with this chronic condition but also pharmacists, NHS service managers, policy makers, commissioners and patient and professional bodies.
Why asthma still kills calls for an end to the complacency around asthma care in order to save lives and highlights four key messages:

  • Every hospital and GP practice should have designated, named clinician for asthma services. 
  • Better monitoring of asthma control; where loss of control is identified, immediate action is required including escalation of responsibility, treatment change and arrangements for follow-up.
  • Better education is needed for doctors, nurses, patients and carers to make them aware of the risks. They need to be able to recognise the warning signs of poor asthma control and know what to do during an attack.
  • All patients should be provided with a personal asthma action plan (PAAP), which can help them to identify if their asthma is worsening and tell them how and when to seek help.

Let us hope we see those asthma fatalities start to drop over the next few years, 1200 deaths a year is simply far too many.

Moulds & damp homes

Insofar as the influence of moulds and damp homes on asthma is concerned there seemed to be no attempt to analyse either in NRAB other than monitoring mould levels in the outside air. This could well be because there are no clear guidelines yet as to how damp or how mouldy a home must be to cause problems to asthmatics.
What do we know? Severe asthmatics tend to be sensitive to moulds. Around 50% of people with unstable, life threatening asthma react to moulds and we know that asthma tends to happen and get worse in damp homes. We have found that treating severe asthmatics with antifungal medication helps ease symptoms in 70% of those treated.

We believe that these facts make it worth looking at the involvement of damp homes and the direct involvement of fungi in asthma and asthma severity more closely and taking precautions such as advising asthmatic people about reducing damp (and thus microbial growth) in their homes, supporting those who look after asthmatic people, raising awareness of the importance of this amongst housing groups, local councils, groups involved in diagnosing and treating damp in the home (surveyors).

If you feel that your home is damp and your asthma is getting worse you can contact us at admin@aspergillosis.org.uk

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Contact us at admin@aspergillus.org.uk