TY - JOUR T1 - Preventing asthma deaths: what can GPs do? JF - British Journal of General Practice JO - Br J Gen Pract SP - 329 LP - 330 DO - 10.3399/bjgp14X680389 VL - 64 IS - 624 AU - Mark Levy Y1 - 2014/07/01 UR - http://bjgp.org/content/64/624/329.abstract N2 - Key implications from the National Review of Asthma Deaths (NRAD) for general practice include: a need to improve accuracy of the diagnosis; recognise and treat asthma as a chronic ongoing disease; to provide asthma action plans for patients; and to ensure that staff delegated to do asthma reviews are appropriately trained.The complexity and workload of GPs has increased against a background of ever-increasing demand and decreasing resources in the UK NHS. However, there are a number of lessons to be learned from the NRAD for healthcare professionals working in primary care. The NRAD, a multidisciplinary confidential enquiry, investigated 276 cases classified with asthma as the underlying cause of death,1 during the year from February 2012. As in previous studies of the medical care provided for people who died from asthma,2–8 the NRAD panel experts identified potentially avoidable factors in over two-thirds of the 195 cases they concluded had died from asthma. These included failure to: perform asthma reviews; to provide patients with personal asthma action plans; to identify life-threatening risk factors; and to follow-up patients after attacks.Three decades ago, asthma was under-diagnosed in primary care, and one of the reasons postulated was that the condition was being treated as if asthma constituted a series of acute attacks rather than an underlying chronic disease.9 At that time, many patients presenting with recurrent respiratory symptoms were inappropriately prescribed antibiotics, and others were treated acutely with nebulised bronchodilators without any attempt at diagnosing the underlying chronic asthma, punctuated by intermittent attacks. Only 71% of the 276 cases classified with … ER -