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Inadequate referrals to secondary care for high-risk asthma patients

According to a new research published in the Journal of Asthma, the majority of high-risk asthma patients in the UK do not receive referral for specialist care, as recommended by national guidelines.

Researchers identified high-risk asthma patients managed in primary care through UK electronic health care records and measured referrals to respiratory clinics in secondary care. High-risk patients included those hospitalised for asthma, ≥three courses of oral corticosteroids (OCS) in a year, incident high-dose inhaled corticosteroid (ICS) and inclusion of a fourth asthma drug in the maintenance regimen. Factors associated with receiving a referral were assessed.

A low proportion of all risk groups received referral to secondary care (<20% of those that need to be referred). The risk group with the highest proportion of referral to secondary care was that of patients with a hospital admission. The factors in the past 12 months that significantly increased the likelihood of referral included a hospital admission or Accident and Emergency visit for asthma, ≥three courses of OCS, ≥two add-on drugs or prescription of high-dose ICS.

Commenting on the findings, the authors said: "This is of great concern as asthma is one of the most common diseases in the UK and has one of the highest mortality rates in Europe. The lack of referrals needs to be addressed urgently if we are to try to prevent further avoidable asthma deaths."


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