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Uncontrolled asthma in primary care: part 1

02 January 2023
Volume 34 · Issue 1


Uncontrolled asthma places patients at risk of asthma attack, hospital admission and death. Andrew Booth highlights strategies that may be used in primary care to identify these patients

This article will help nurses to identify uncontrolled asthma in a primary care setting, and support the identification of people who may be at risk from asthma attack, hospital admission or death. Guideline-defined asthma control is covered, along with the appropriate tools used to measure asthma control. The difference between asthma severity, asthma control and risk of attack is discussed, with practical advice from national and international asthma guidelines. Strategies and interventions that may be of use in primary care are highlighted, and a look at how research is helping identify new ways of supporting people with uncontrolled asthma.

This article will help nurses to identify uncontrolled asthma in a primary care setting, and support the identification of people who may be at risk from asthma attack, hospital admission or death. Part two of this article will consider how to support and manage people with uncontrolled asthma, and people who may be at risk.

Asthma is a variable respiratory condition, characterised by bronchoconstriction and inflammation of the inside of the airway. The four main symptoms include cough (which is usually unproductive), wheeze (heard on auscultation), chest tightness and breathlessness. Most people with asthma have more than one symptom, which occur in the presence of known triggers (British Thoracic Society/Scottish Intercollegiate Guideline Network (BTS/SIGN), 2019; Global Initiative for Asthma (GINA), 2022). Nearly four people die from asthma every day in the UK, with many of these deaths being preventable (Royal College of Physicians, 2014; British Lung Foundation, 2022). Poor asthma control places a significant burden on health services as well as individuals with asthma, as it can lead to increased number of asthma attacks, hospitalisations and death (Peters et al, 2006).

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