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Significant shortfalls in recommended asthma follow-up care after hospitalisation

Over 80% of asthma patients hospitalised following an asthma attack are not getting appropriate follow-up care, a new study has found.

Data collected by the University of Birmingham, and published in the British Journal of General Practice, shows that only 18% of hospitalised asthma patients had a GP appointment within the recommended 48-hour period post-discharge.

The findings were worse for black patients, and the researchers suggest there are ‘serious inequalities’ in the follow-up care received.

Using electronic healthcare records collected between 2017 and 2019, the researchers analysed data from more than 17,000 patients over the age of five.

The findings show that the current recommendations for follow-up care of asthma patients are not being met, and primary care appointments after hospitalisation are falling far outside the 48-hour window for most asthma patients, with many waiting months for a review.

While 82% did not receive the recommended follow-up care within 48 hours, only 60% of patients had a primary care follow-up within 28 days post-hospitalisation.

Further evidence suggests that while just over half of patients received medication following an appointment, only 13% of patients were offered asthma reviews, and just 8% were offered management plans.

Senior author of the study, Dr Shamil Haroon, clinical epidemiologist and associate clinical professor of public health at the University of Birmingham‘s Institute of Applied Health Research, said: ‘Not only are most patients not getting care in the recommended time frame 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.’

The inequalities highlighted in the study also showed that black patients receive less care associated with their asthma management. The researchers estimate that depending on their age, black patients were between 27% and 54% less likely to receive the level of care that their white peers were provided.

Dr Prasad Nagakumar, paediatric respiratory consultant at Birmingham Children’s Hospital and senior author, added: ‘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.’

A version of this article was originally published by our sister publication Nursing in Practice.

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