News and Updates

Tuesday 04th May 2021- World Asthma Day

"World Asthma Day", text by Dr Mark L Levy
Clinical Lead Asthma Radar WSIC
Member of the Global Initiative on Asthma (GINA) Board of Directors 

Clinicians have many misconceptions related to asthma such as:
Asthma is a mild disease; Asthma control only needs to be assessed once a year; and 
Blue reliever inhalers are the mainstay of asthma treatment.

All of these are clearly misconceptions and therefore wrong:
•    About 30% of people who die from asthma have ‘so called mild asthma’. So in fact even people with asthma who have symptoms less than twice a month are at risk of poor asthma outcome, including death. 
•    Asthma is a chronic ongoing disease prone to flare-ups or attacks and therefore asthma control needs to be assessed frequently. In particular, asthma control is defined in two domains – symptoms and risk factors such as attacks. So therefore, asking someone with asthma how they are on only one occasion a year only establishes control at that time! 
•    There is good evidence now that regular use of short acting reliever inhalers puts patients at risk of poor asthma outcomes, including unscheduled utilisation of services, asthma attacks and even death. So prescribing in excess of three reliever inhalers a year puts patients at risk particularly if this is without regular preventer medication in the form of inhaled corticosteroids – which protect against attacks.

WSIC Asthma RADAR: Clinicians in NW London have the benefit of an evidence based, up to date asthma risk register, in the form of the Asthma Radar. Clinicians have access to the WSIC dashboard page and the Asthma RADAR which enables  identification (ie by the presence of RED Dots) of  those patients who are at risk. For example including those who have had more than 1 attack, been prescribed excess reliever medication, or insufficient inhaled corticosteroids in the last 12 months.

A recent review of 14450 Children and Young People (CYP) using the WSIC Database showed that many children are at high risk of poor asthma outcome and from available data less than 20 of the 350 NWL practices are accessing this resource which could facilitate improved asthma care, reduced avoidable attacks and deaths, and substantially reduce the cost of preventable unscheduled care for asthma. 

Further reading:
i)    GINA 2021- (28./4.2021); videos, podcasts, learning tools, Full strategy and short GP Booklets summarising the guidance  – www.ginasthma.org
ii)    Levy ML. Risks of poor asthma outcome in 14,405 children and young people in London 2021 [updated 2021/01/29. 3]. Available from: https://www.nature.com/articles/s41533-020-00215-7 
iii)    Why asthma still kills: The National Review of Asthma Deaths (NRAD) Confidential Enquiry report Royal College of Physicians. London; 2014. Available from: https://www.rcplondon.ac.uk/projects/outputs/why-asthma-still-kills 
iv)    Demonstration of the Asthma RADAR: https://www.youtube.com/watch?v=m8QMCHjC7IU 
v)    SIGN/ BTS Asthma Guideline (Dated 2019) : https://www.sign.ac.uk/our-guidelines/british-guideline-on-the-management-of-asthma/ 

Tuesday 04th May 2021- World Asthma Day

text by Dr Stephen Goldring
Consultant Paediatrician
The Hillingdon Hospitals NHS Foundation Trust

Following the tragic deaths of two children from asthma in NWL in the last 9 months, this World Asthma Day 2021, the NWL children's asthma network are launching an initiative to target high-risk patients across the region. Lessons learned show how important it is to identify high SABA users AND make sure patients are effectively reviewed after each acute asthma attack. These two factors are a clear sign that asthma is not under control, and the child is at risk of a serious asthma attack. Many of these children are simply not taking, or have not been prescribed regular inhaled corticosteroids.   

Right now, we know there are 225 children and young people across NWL who have used 6 or more SABAs in the last 12 months, and our aim is to make sure all these patients are effectively reviewed.

What can you do?  

1.    Meet, search and review!  Meet as a team - GP, Practice nurse and pharmacist. An hour is plenty to get started. Search using the WSIC asthma radar, starting with the highest SABA users in your practice. Have they had an asthma attack? Are they taking their preventer inhalers? Has their inhaler technique been checked? Do they have an asthma plan? Get them reviewed and consider referring to your local asthma service.

 
2.    For training, please join the “Effective Asthma Care for Children and Young People” virtual programme. This is a 6 week online course starting Thursday 6th May 9-10am. (See flyer here). 

Thursday 29th April 2021- International Day of Immunology

The International Day of Immunology is dedicated to increasing global awareness of the importance of immunology in the fight against infection, autoimmunity, and cancer.

Immunology’s never had such a high public profile as now during the COVID-19 pandemic. The WSIC team is pleased to support the International Day of Immunology. We continue to deliver both the COVID-19 and the Flu Vaccination dashboards for Primary Care and CCG users across North West London.

Our dashboards have been helping to support the planning and delivery of the COVID-19 and Flu Vaccination programmes through these challenging times. 

WSIC COVID-19 and Flu Vaccination dashboards provides health and social care users within NWL with a view of the vaccine uptake for the population, ensuring groups of at risk patients are effectively identified. This contributes to a better quality of care, as clinicians can target patients’ cohorts proactively - ensuring groups of patients are optimally managed.