Executive summary
Asthma deaths have increased by nearly 25% since 2014 and basic asthma care – including vital guidance on how to correctly use inhalers – is given to fewer than 1 in 3 people with asthma each year despite being advocated by national guidelines. Basic asthma care should be the norm, and limited access to this care increases a person’s likelihood of having an asthma attack, being hospitalised, or dying.
Following the new national asthma guideline published by BTS, NICE and SIGN in November 2024, Asthma + Lung UK is calling for better care for the 7.2 million people in the UK with asthma. The guideline presents a key opportunity to review and improve inhaler care, revolutionising asthma treatment through new approaches to treating asthma and expanding access to basic asthma care to improve health outcomes.
The new guideline makes ICS-formoterol the reliever of choice for most people with asthma. Where this isn’t the case, healthcare professionals should ensure concurrent prescribing of inhaled corticosteroid (ICS) with a SABA inhaler as reliever. In all cases an appropriate personalised asthma action plan should be completed and shared with the patient to outline how to self-manage their condition.
A key part of good care is having the right inhaler, which may mean switching from one inhaler to another. This is a key opportunity to optimise a person’s asthma care and ensure they are receiving the best care. However, our survey of those who have had their inhaler changed recently found a worrying situation, and patients are clearly in need of significantly more clinical support.
We found that:
- 22% of people were switched with no appointment to oversee and explain the switch.
- A third of patients say their condition control is worse after their inhaler has been switched.
- 39% of people who have their inhaler switched aren’t given any inhaler technique guidance at all.
- Of those who were given some form of inhaler technique guidance, only 19% received gold standard guidance, while only 27% were shown how to use it, and just 33% were either told how to use their inhaler or were given a web link or leaflet.
- 20% of people who switched their inhaler reverted to their old treatment.
- 10% of those who revert to their old inhaler did so without telling their GP, likely by buying inhalers online.
- 20% of people who switched their inhaler reverted to their old treatment.
- 10% of those who revert to their old inhaler did so without telling their GP, likely by buying inhalers online.
The vast majority of patients who have had their inhalers switched over the last few years have not been appropriately supported by the NHS which diminishes trust and can potentially impact future adherence. With new asthma guidelines offering a crucial opportunity to improve outcomes, it is essential that the NHS as a whole improves performance in this area and better supports patients being moved onto new inhalers in future.
This is about getting the basics right year-round, building patient safety into every aspect of asthma care, and supporting people with asthma.