AST015 - Asthma annual review
The codes referenced in this article are taken from the NHS Technology Reference Update Distribution (TRUD). Not all of these may be present or selectable in all clinical systems.
The information contained within this article is from version 51 of the Business Rules for Quality and Outcomes Framework (QOF).
Indicator definition
Indicator ID | Description |
AST015 | The percentage of patients with asthma, on the register, who have had an asthma review in the preceding 12 months that includes an assessment of asthma control, a recording of the number of exacerbations, an assessment of inhaler technique and a written personalised asthma plan. |
This is identical to the business rules for AST007 but based on a register that includes patients aged 5+ instead of AST007 which was 6+
What do the business rules mean?
What makes a patient eligible?
Patients are eligible for the AST015 denominator if they are on the Asthma register.
How to achieve the indicator
Patients must have completed all the requirements of the review to pass the indicator:
- a completed asthma review
- a written care plan (on the same day as an asthma review)
- a recording of the number of exacerbations (between 1 month before the asthma review up until the date of an asthma review)
What will remove patients from eligibility?
- Patients for whom asthma quality care was unsuitable in the contract year
- Patients who choose not to receive monitoring in the contract year
- Patients who chose not to receive any asthma quality indicator care in the contract year
- Patients who have not responded to two invitations for an asthma review at least 7 days apart in the contract year
- Patients who were diagnosed with asthma in the last 3 months of the contract year
- Patients who were newly registered with the practice in the last 3 months of the contract year
If a patient achieves the
indicator at any point during the year, any exclusions that have also been
added are ignored.
What are the common pitfalls/what do I need to watch out for?
Clinicians not completing all of the required data points for the review within the correct time frame is a common reason for not performing on this indicator.
While the 3 components do not have to all be coded on the same day, this is the easiest way to ensure a complete review is done. Note that the Care Plan must be added on the same day as a review, but it is possible to document number of exacerbations on a different day (as long as it is followed by a review within the next month/30 days).
- In theory, multiple asthma reviews can be conducted during the contract year. As long as the care plan and number of exacerbations are within the required timeframes of any asthma review code, the patient will achieve the indicator.
- Not coding asthma invites correctly will often be a reason for not hitting this target.
Despite being referenced in the indicator description Inhaler technique is not actually a required coded component for QOF, and assessment of asthma control was removed as a component from v50 onwards.
SNOMED codes used in this indicator
The codes referenced in this article are taken from the NHS Technology Reference Update Distribution (TRUD). Not all of these may be present or selectable in all clinical systems.Codes for asthma review (REV_COD)
| Code | Display |
|---|---|
| 390878008 | Step down change in asthma management plan |
| 401183006 | Asthma monitoring by doctor |
| 401182001 | Asthma monitoring by nurse |
| 390872009 | Change in asthma management plan |
| 754061000000100 | Asthma review using Royal College of Physicians three questions |
| 275908000 | Asthma monitoring |
| 270442000 | Asthma monitoring check done |
| 394701000 | Asthma follow-up |
| 390877003 | Step up change in asthma management plan |
| 394700004 | Asthma annual review |
| 394720003 | Asthma medication review |
Codes for written personalised asthma action plan (WRITPASTP_COD)
| Code | Display |
|---|---|
| 810901000000102 | Asthma self-management plan review |
| 811921000000103 | Asthma self-management plan agreed |
| 527171000000103 | Patient has a written asthma personal action plan |
Codes for the number of asthma exacerbations in the last year (ASTEXACB_COD)
| Code | Display |
|---|---|
| 366874008 | Number of asthma exacerbations in past year |
Codes for asthma quality indicator care unsuitable for patient (ASTPCAPU_COD)
| Code | Display |
|---|---|
| 717291000000103 | Excepted from asthma quality indicators - patient unsuitable |
Codes indicating the patient has chosen not to receive asthma monitoring (ASTMONDEC_COD)
| Code | Display |
|---|---|
| 763221007 | Asthma monitoring declined |
Patients who have chosen not to receive any asthma quality indicator care (ASTPCADEC_COD)
| Code | Display |
|---|---|
| 716491000000100 | Excepted from asthma quality indicators - informed dissent |
Patients who have been invited twice for an asthma review at least 7 days apart (ASTINVITE_COD)
| Code | Display |
|---|---|
| 928451000000107 | Asthma monitoring invitation SMS (short message service) text message |
| 1110841000000103 | QOF (Quality and Outcomes Framework) asthma quality indicator-related care invitation |
| 185735009 | Asthma monitoring call verbal invite |
| 928511000000107 | Asthma monitoring invitation email |
| 959421000000105 | Asthma monitoring SMS (short message service) text message second invitation |
| 959401000000101 | Asthma monitoring SMS (short message service) text message first invitation |
| 1109921000000106 | QOF (Quality and Outcomes Framework) quality indicator-related care invitation |
| 959441000000103 | Asthma monitoring SMS (short message service) text message third invitation |
| 185731000 | Asthma monitoring call first letter |
| 185736005 | Asthma monitoring call telephone invite |
| 92161000000104 | QOF (Quality and Outcomes Framework) asthma quality indicator-related care invitation using preferred method of communication |
| 185734008 | Asthma monitoring call third letter |
| 185732007 | Asthma monitoring call second letter |