National Institute for Health and Clinical Excellence (NICE)
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Asthma quality standard could "change lives of millions"

NICE's quality standard on asthma could improve the lives of millions by driving up the quality of care for people with the condition, say experts.

Asthma is the most common long-term medical condition in the UK, with around 5.4 million people currently receive treatment for asthma, 1.1 million of whom are children.

Treatment goals are to help people manage their condition, and to lead symptom-free, normal, active lives. This is because a cure is not usually possible, as the causes of most forms of asthma are not fully understood.

The NICE quality standard for asthma contains 11 measures to help improve the diagnosis and treatment of the condition in adults, young people and children.

The statement includes a measure for the number of people with newly diagnosed asthma are diagnosed in accordance with BTS/SIGN guidance.

NICE says it is important to clearly record the basis on which the diagnosis of asthma is made, because the process may have implications for the future management of the condition.

Occupational asthma, where asthma develops in adults due to exposure in the workplace, is the only form of the condition that can be potentially cured by removing people from exposure to the triggers that cause.

Research published in January highlighted that workplaces are responsible for one in six cases of adult onset asthma, and that raising awareness is a major step towards reducing the incidence of this almost entirely preventable disease.

NICE says healthcare professionals need to be able to recognise symptoms suggestive of occupational asthma so that they can ensure appropriate referral and treatment.

The standard also contains a measure that people with asthma receive a written personalised action plan.

The rationale for this is that action plans can improve outcomes such as self-efficacy, knowledge and confidence for people with asthma when given as part of structured education. This is particularly the case for those with moderate to severe asthma whose condition is managed in secondary care.

Additional statements measure the number of people with asthma who receive a structured review at least annually, and the number with asthma who are given specific training and assessment in inhaler technique before starting any new inhaler treatment.

Emily Humphreys, Head of Policy and Public Affairs at Asthma UK, said: "We're delighted that a quality standard is now in place for asthma. This will really help to improve the quality of care provided for one of the most common long-term conditions - so it's no exaggeration to say that if this is successful, it could change millions of lives.

She added: "We're particularly pleased to see the inclusion of personal asthma action plans. People who have an action plan are four times less likely to need to be admitted to hospital, but only a tiny proportion of people with asthma are currently offered one.

"Making sure this is implemented will be the next key test of asthma care in the NHS."

Professor Sue Hill and Dr Robert Winter, joint National Clinical Directors for Respiratory Disease, said: "Asthma is an area where we can, and should, be doing so much more. This new NICE quality standard is a great step forward as it reinforces those areas where best practice and guidelines should be applied.

"If we address the areas of care highlighted in this quality standard, then we should see significant improvements in outcomes for people living with asthma and their overall quality of life."

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