🌪️ Asthma Exacerbation

💷 How much is this worth to me?

While this template is not directly linked to QOF payment, it plays a vital role in:

• Contractual safety and quality reviews (e.g. IIF respiratory indicators)

• Medicines optimisation reviews

• ICS-level asthma audits

• Post-exacerbation follow-up (NICE guidance NG80)

Accurate documentation of asthma attacks supports better care planning, helps prevent future admissions, and identifies patients needing a step-up in treatment or referral.

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📊 High-level overview of the specification requirements

National guidance recommends a structured review after every asthma exacerbation. This template ensures:

• Clear recording of the exacerbation event

• Review of inhaler technique

• Check of adherence and trigger avoidance

• Update to the patient’s management plan

• Coding of action taken, including escalation if needed

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📌 What do you need to know?

The template is structured around a post-attack review:

🚑 Exacerbation Event Details

• Date of exacerbation

• Trigger, if known (e.g. viral, environmental)

• Management:

  • Oral steroids?

  • ED attendance?

  • Admission?

💊 Medication Review

• Current preventer medication recorded

• Check inhaler use pattern pre- and post-attack

• Assessment of adherence and any overuse of reliever

🧠 Understanding and Triggers

• Review and re-educate on:

  • Difference between preventer and reliever

  • Trigger avoidance

  • Symptom monitoring

💨 Inhaler Technique

• Prompt to check and document inhaler technique

• Educational resources linked (e.g. Wessex AHSN videos)

📋 Asthma Management Plan

• Confirm presence of a written action plan

• Option to review or reissue plan

• Encourage carrying of reliever inhaler at all times

📅 Follow-Up and Referral

• Consider:

  • Stepping up treatment

  • Referral to asthma clinic or respiratory specialist

• Code safety-netting and planned follow-up

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💡 Hints and Tips

• Post-exacerbation reviews should ideally take place within 2–3 working days of an acute event

• Use the review opportunity to reassess asthma control and escalate if needed

• Ensure accurate coding of the exacerbation event to support internal audits

• Patients with 2 or more exacerbations in a year may need a full respiratory MDT review

• Be vigilant for red flags: poor understanding, poor adherence, high reliever use