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Wednesday, August 25, 1999 Published at 23:11 GMT 00:11 UK


Call to fight asthma lottery

Asthma affects up to one in 20 of the UK population

The UK's 3.4 million asthma sufferers face a care lottery which only a set of national standards will improve, say experts.

The National Asthma Campaign (NAC) and the Royal College of Physicians (RCP) are calling on the government to set up a National Service Framework or similar procedure to monitor how patients are treated and boost outcomes.

They say asthma costs the NHS £672m a year and leads to 85,000 hospital admissions a year and, as such, should have greater priority.

However, a survey of health authorities in England shows only 18 out of 70 say asthma would be included in health improvement programmes.

Varying standards

Dr Martyn Partridge of the NAC says the standard of care offered to patients varies widely across the country.

In Leicester, where an asthma task force exists, care is audited and patients encouraged to manage their own treatment.

In other parts, practice nurses are specially trained to help asthma patients.

But in many parts of the country, patients can only grab a few minutes with their GPs.

"Because there is no national monitoring, we can only guess whether innovative methods of dealing with asthma are more effective," he said.

But he added that "evidence from around the world suggests an approach which helps people manage their own care and adjust to different circumstances works best".

Three questions

As part of its efforts to get the government to set up national standards, an RCP expert group has come up with three simple questions which it says will help doctors and patients assess whether their treatment has been effective.

The questions to be put to adult asthma patients are:

  • In the last week (or month):
  • Have you had difficulty sleeping because of your asthma symptoms?
  • Have you had your usual asthma symptoms during the day?
  • Has your asthma interfered with your usual activities?

The RCP says the answers, which could be fed into a GP's computer, could be asked at every consultation and would help to build a picture of overall well-being of asthma patients in a particular clinic or area.

[ image: Experts want national standards for managing asthma treatment]
Experts want national standards for managing asthma treatment
These could then be compared with outcomes across the country.

Dr Mike Pearson of the RCP said: "At the moment it is like a tug of war, but if we co-ordinate things we can have more success. Only Department of Health support will give us that."

He added that it was the first time in the world that asthma experts had come together to develop a set of questions which reflected patients' concerns about their illness.

"People who answer yes to all three questions are more likely to be admitted to hospital or have to go on steroids," said Dr Pearson.

He added that the aim was not just to improve treatment for the very ill who represent a minority of patients, but to stop people seeing asthma as a handicap which, for example, might stop them doing sport or result in days off work, affecting their promotion prospects.

The government has set national standards for several illnesses, such as cardiac problems.

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