Abstract

Introduction
Asthma exacerbations are common events associated with significant heterogeneity. Patients' understanding of these events is unclear, and the recovery process after discharge from secondary care is unexplored, particularly with primary care interactions post-discharge.
Aim
The aim was to evaluate the asthma service provided at Kingsmill Hospital (Mansfield, England) from a patient perspective against national standards. The second aim was to explore recovery from asthma exacerbation from a patient’s perspective and interactions with primary care after an exacerbation.

Method
To explore recovery from previous asthma exacerbations, semi-structured interviews of patients admitted for an asthma exacerbation were undertaken. Verbatim transcripts were analysed using the framework approach. Two weeks after discharge, participants were contacted to review their admission from the current exacerbation and interactions with services post-exacerbation.
Results
Of the fifteen participants (73% female, mean age 57), most (n=11) had GINA step 3-4 asthma, and 4 had step 5 asthma.
Five emergent themes were identified. Recovery varied between patients, and the emotional impact of recovery varied. Those who responded well to steroids (N=10) felt “euphoric” or “energised,” but that feeling would go away within a few weeks. However, there were some (N=5) for whom steroids provided limited benefit and were associated with fatigue and persistent symptoms that prevented them from undertaking their activities of daily living.
Seven patients were unsure of the cause of their asthma exacerbations. All patients were given instructions on using their inhalers, but some found this of limited benefit. Patients valued the care the secondary care team and asthma nurse specialists provided.
Conclusions
Patients’ recovery from asthma exacerbations is variable. In some, recovery was longer than the treatment length. 19% of participants sought primary care help before their secondary care follow-up appointment. Better patient education and tailored communication during asthma exacerbations is essential.