Resources for practices delivering asthma care New NHS guides to help patients manage their asthma: Mid Yorkshire Hospitals NHS Trust put together a range of helpful videos (on YouTube) in different languages about staying well with asthma. The videos include guidance on inhaler and medication use, action plans, and hospital visitation. Languages currently available include Arabic, Bengali, English, Gujarati, Hindi, Polish, Punjabi, Somali, Urdu and Welsh. Videos are also available regarding medication use during Ramadan.
The videos can be accessed via QR codes on the following poster which could be displayed in your patient waiting area:
Regular clinical review is a crucial component of supporting people with asthma to live with their asthma. Two of the IMP2ART patient colleagues discuss why they find regular reviews help them live with asthma.
Video clip: IMP2ART patient colleague David explains why an annual asthma review is essential
Video clip: IMP2ART patient colleague Olivia tells us why an asthma review is useful, even for patients with severe asthma
The tasks of a regular asthma review
The Quality and Outcome Framework rewards an annual review, but in practice the frequency of review depends on the clinical context as well as the broader social and demographic context. The key tasks of a review, as described in guidelines [BTS-SIGN and NICE] are as follows. The IMP2ART template provides a structure for working through all these tasks:
- Establish any concerns that the patient may have about their asthma
- Discuss self-management and provide/update the action plan
- Assess control with a validated questionnaire such as ACT and ACQ
- Assess risk of future attacks indicators of high/low risk
- Discus allergies and triggers
- Discuss treatment options treatment steps according to guidelines
- Check inhaler technique
Guidelines for the management of asthma: BTS-SIGN and NICE guidelines on the BTS website
The tasks of a review and alternative modes of consultation
The matrix below indicates what can be achieved in a face-to-face, video-consultation, telephone review and the tasks that can be supported by an online questionnaire. Click on the icons to read about IMP2ART resources to support the various tasks and strategies for completing tasks using the different modes of consultation.
Establish patient concerns
Provide/update the action plan
Assess symptom control
Assess risk of future attacks
Discuss rhinitis and allergens
Discuss treatment options
Check inhaler techniqueChoice of mode of review
Traditionally most asthma reviews in primary care have been delivered face-to- face, but during the COVID-19 pandemic we have all learnt to review people using telephone, video-consultations and/or on-line questionnaires. This has proved popular with many people but once coronavirus has receded and the need for social distancing has passed, we will be able to offer patients a choice of mode of review to suit their clinical situation and preferences. The IMP2ART review invitation letter offers choices.
- IMP2ART review invitation letter [56 KB Word]
Why a remote asthma review?
Many patients welcome the option of a remote review for a number of reasons e.g. transport difficulties, work or other commitments, that make attending a review in the surgery difficult.
Video clip: GP, Professor Hilary Pinnock, discusses the benefits of remote asthma reviews for both patients and practices
Video clip: GP, Professor Hilary Pinnock, discusses how a remote asthma review can be carried out effectively
Video clip: GP, Professor Hilary Pinnock compares asthma reviews carried out remotely by telephone or video
Telephone review
Telephone reviews will be an option for patients who are happy to have a remote review but do not have access to video facilities or would prefer a telephone review. Patients tell us that telephone reviews work best when they receive information about their review prior to their appointment. An existing relationship with the clinician who is carrying out the review can make the review work well. Further information is available on the telephone review page.
Video consultation
Video reviews provide a good alternative to face-to-face reviews. They work best when both clinicians and patients have the privacy and access to the appropriate technology to participate in this way, and are confident using the technology. This includes access to good size screens so that both parties can participate fully; for example, patients can demonstrate inhaler technique, and completing the action plan can be done together. Further information is available on the video consultation page.
Online questionnaire
Patients can complete a questionnaire that has been designed to provide an overview of their asthma control, risk of an attack, ownership of an action plan and other relevant aspects of their health. The responses can prompt an informed decision about appropriate arrangements for further review. Further information is available on the online asthma questionnaire page.
Some FAQs about asthma reviews
FAQ1 How can we improve attendance at asthma reviews in our practice?
- Strategies for improving attendance rate at asthma reviews [269 KB PDF]
- Strategies for improving attendance rate at asthma reviews - text only version [33 KB Word]
FAQ2 How can we update our appointment system post-COVID?
- Suggestions for improving the appointment system once the COVID pandemic recedes [275 PDF]
- Suggestions for improving the appointment system once the COVID pandemic recedes - text only version [30 KB Word]
FAQ3 How can we reduce DNAs?
