Suspected Asthma – Do They Deserve Better Treatment?
Quality Improvement Project to Enhance the Safety for Patients with Suspected Asthma (ID 496)
Fenland Group Practice
Funding: None
Abstract
Background:This quality-improvement project aimed to deliver comprehensive reviews to patients who had a recorded diagnosis of ‘suspected asthma’ but had not undergone an asthma review in the past year.
Of 68 patients with ‘suspected asthma’, only 38% had annual asthma reviews in the past 12 months.
Meanwhile, 80.6% for those in the asthma register had the review at Fenland Group Practice in 2023-2024.
Method:
SystemOne (GP electronic health care record system) individual patient records were reviewed to answer following:
1. How did they initially present? – clinical probability based on the notes
2. When was the last time they were prescribed an inhaler
3. Is the suspected asthma diagnosis likely to be historic? – ‘have they grown out of it?’
4. Have they had any diagnostic tests to confirm or refute the asthma diagnosis.
Results:
All 44 patients who had clinical record reviewed, and some of them were invited for face-to-face reviews.
14 patients were formally diagnosed with asthma and added to asthma register.
28 patients were found NOT to have asthma – coding was either historic or inaccurate, or they had tests to rule out asthma.
2 patients had their status unchanged. One of them declined further input, and one failed to attend the review.
Discussions and conclusions:
1. It is important to proactively review patients with suspected asthma as they can easily slip through the net.
2. Suspected asthma should generally be a provisional diagnosis while patients wait for diagnostic testing or further review.
3. It is crucial to document the clinical reasoning that led to the working diagnosis of suspected asthma.
4. Good access to local diagnostic services is a key factor that improves the diagnostic timeline and adherence to NICE guideline for asthma.
Conflicts of interest: None
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