http://www.bbc.co.uk/news/health-27257911



Funnily, the Torygraph took a different approach:




Given that I work in general practice and went to a university that was hot on things like asthma, I have a few points I'd like to make:

• Diagnosis can be later because it's not always picked up, or presented. I've had patients who've ignored their cough for years
• Patients often don't bother turning up for asthma checks. Although it's lambasted in the Torygraph, nurses basically do a screening and a peak flow. If there are any concerns, the patient gets booked in to see a GP for optimising their control.
• Patients often don't take their inhalers or lie about doing so. One of our professors gave patients inhalers with a microchip which recorded usage. Most of the patients who had problems simply hadn't taken their inhaler. A few had managed to use their entire doses in the ten minute drive to the hospital!
• We give our patients asthma leaflets and ensure they know what to do when there's a flare of their symptoms. Despite this, not everyone does as recommended
• Patients often don't like the idea of taking steroids, even in inhaled form. They get immediate benefit from their reliever, see no benefit from their preventer and hence don't bother using it. Reinforcing positive education would help.
• Sometimes patients can have exacerbations through no fault of their own. They might be admitted to hospital. The better hospitals get the patient seen in the respiratory clinic soon after the admission. The crap ones tend to ask the patient to see their GP.
• Not every GP surgery has in-house spirometry. We do and our nurse goes on a regular calibration course to check she's up to scratch. This alone would save patients hassle as they then don't have to go to hospital for the same thing.
• Cost. Having to have two inhalers generates a prescription charge of over £15. Over a year that's £180. Some people can afford it. Some go for pre-payment. Some can't afford it and go without. IMO it should be free as per patients on thyroxine.

I don't know how many practice do "on the day" appointments only, but I know that these are really offputting for people with chronic conditions that just need a follow up.Same for wanting to see specialists. Follow up appointments seem to be pushed back in the benefit of people experiencing acute events.

Not taking treatment has no excuse though.

Someone I know has just been diagnosed with Asthma - so inhalers etc. are new to him. I was diagnosed when I was six, so I’ve had a lifetime of syrups and inhalers. MY mum is also asthmatic (but she seemed to grow out of it), and she remembers unpleasant injections as a child. Current asthma management is worlds away from when I was a child.


I remember having to talk to a friend of my mum’s who was really scared of taking steroids for her asthma. I did some basic reading up - yes, they are steroids, no they act differently to the “body builder” variety, no they don’t stick around in your system for too long.

I’m certainly with you on the free prescriptions bit. I’ve got a reliever and a preventer, and the two together can make for a large payment at the pharmacy counter. For my use, a pre paid certificate is just that much more than I’d spend in a year.

All this reminds me - I have to book an appt with the asthma clinic where I am.

A friend's dad was given steroids (I'm assuming for his asthma, and you know it didn't stop him smoking after losing a lung ) - his hair started to grow back