Asthma Exacerbation

Asthma Exacerbation

🌪️ 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.

📊 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

📌 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

💡 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