PCRS-UK Asthma Audit

Data collection form - Use 1 per patient

Practice ID: Your membership Number:- ______(see member email about this audit if you do not know your membership number or contact us
at )

Patient ID number for audit ______(use sequential numbering starting with 1 for the first patient – do not use the real patient ID
number)

Patient age range (minimum 5 years of age)

 Child  Teenager  Adult

Real Patient ID ______For your reference only – not to be recorded on the audit system

1. Who saw the patient last for a review of their asthma or during an acute asthma episode?

(For this we suggest you ask the patient and confirm via patient records if possible)

 Asthma specialist nurse / practice nurse (with asthma diploma)

 Practice nurse

GP

 Secondary care specialist (physician / nurse)

 A&E / Out of hours / emergency services

2. Is the preventer medication being taken as expected over the last year?

(For this we suggest you check on the number of prescriptions given over the last year and discuss with the patient)

 More than would be expected

 Close to perfect preventative medication uses (around 3/4 of expected or more)

 Some problems with preventative medication use (around 1/3 to 3/4 of expected use)

 Poor preventative medication use (less than 1/3)

3. How many SABA inhalers have been prescribed in the last year for this patient?

 1-2 inhalers

 3-6 inhalers

 7-11 inhalers

 12 or more SABA inhalers

4. How good is symptom control?

(Answer based on RCP 3 questions – see also )

Good control ('no' to all three questions)

Likely to have good control (1 positive response)

Likely to be poorly controlled and needs further assessment (2 positive responses)

Poor control (3 positive responses)

Interpretation of the RCP three questions (RCP3Q) scores in clinical practice
RCP3Q / Interpretation
0 / Good control
1 / Likely to have good control (1 positive response)
2 / Likely to be poorly controlled and needs further assessment (2 positive responses)
3 / Poorly controlled
Exacerbations and use of reliever inhalers reflect a different aspect of control and should be explored independently

5. How many unused / unopened reliever inhalers does the patient have? (SABA only)?

______quantity

6. Does the patient routinely order additional supplies of SABA when they obtain their repeat prescription irrespective of whether they require their SABA prescription to be filled?

 Yes

Yes, Pharmacist orders this for the patient

 No

7. Does the patient pay for prescriptions?

 Yes (per item)

 Yes, Bulk Pre-payment

 No

NOW ENTER THIS PATIENT’S RESULTS ON THE ONLINE SYTEM AVAILABLE HERE AND FILE FORM WITH PATIENT RECORD

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