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Specification of the Audit

Title: Unscheduled attendance at General Practice Surgeries for Uncontrolled Asthma Episodes (The UNSAFE AUDIT)

Aims of audit:

  1. To determine the prevalence of diagnosed asthma by age and gender in primary care centres
  2. To establish practice diagnosis and prescribing patterns when caring for patients' episodes of uncontrolled asthma.
  3. Through comparison with colleagues' online data, and that of guidelines, to facilitate change in prescribing and management of patients attending with episodes of uncontrolled asthma.

Audit Criteria:

To include demographic data on diagnosed asthma patients in primary care, clinicians' geographic location and expertise. Specific anonymised data on presentation, management, education and disposal of patients treated for episodes of uncontrolled asthma.

An unscheduled attendance for asthma is defined:

  1. where asthma was the principal reason for the consultation and
  2. the consultation was not pre-arranged or solely for the purpose of a routine review or repeat prescription.

Audit standards for patients treated for unscheduled attendances of uncontrolled asthma:

Uncontrolled asthma is potentially life-threatening, and with this in mind we have set a high standard of achievement for most of the indicators to be derived from this audit.
  1. At least 90% of patients with a prescription for asthma medication should have a recorded diagnosis of asthma.
  2. At least 80% of patients with a recorded hospital admission for asthma in the previous 12 months should be on preventer medication.
  3. At least 80% of patients with a recorded hospital admission for asthma in the previous 12 months should have been issued with a personal asthma self-management plan.
  4. At least 80% of patients seen for an uncontrolled episode of asthma should have had their Peak Flow measured before treatment.
  5. At least 80% of patients treated with high-dose bronchodilators for an uncontrolled episode of asthma should have had their Peak Flow measured after treatment.
  6. 100% of patients treated with high-dose bronchodilators for an uncontrolled episode of asthma should have been taught to use their inhaler device at that consultation.
  7. At least 80% of patients treated with high-dose bronchodilators should also have been treated with systemic steroids.
  8. 100% of patients treated with high-dose bronchodilators should have a record detailing arrangements for follow-up of the episode.
  9. At least 80% of patients treated for an episode of uncontrolled asthma should have a new or modified existing personal action plan for asthma.

Relevant links:

  1. Guidelines
    1. SIGN
      http://www.sign.ac.uk/guidelines/fulltext/101/index.html
    2. GINA
      http://www.ginasthma.com/
  2. GPIAG
    http://www.gpiag.org
  3. Asthma Self Management Plan:
    http://www.consultmarklevy.com/webcasts/actionplans/player.html
  4. Asthma UK
    http://www.asthma.org.uk/
 

 


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