Inhaler concerns raised following asthma death

An asthma charity has called for better monitoring of the use of inhalers after the death of a 22-year-old following an asthma attack.

Roman Barr from Coventry died in December 2023 and a coroner's report, released last week, noted he had used his inhaler "more frequently than recommended".

Karen Spillett, deputy head of health advice at Asthma + Lung UK said: "We know that overusing reliever inhalers over a long period of time can signal poor asthma control and increase the risk of a severe or fatal asthma attack."

The charity said emergency admissions for asthma were steadily rising and the health service needed to improve the monitoring of inhaler use.

The inquest concluded that ambulance delays contributed to Roman Barr's death and that "earlier intervention by an emergency ambulance would have prevented his death".

Following the inquest, the Coventry coroner Linda Lee completed a prevention of future deaths report, in which she also raised concerns about inhaler overuse.

In her conclusions she said Barr's local GP practice had carried out a review following his death and had introduced measures to better identify and monitor patients "with high salbutamol use".

But she said there was evidence that excessive repeated requests for these inhalers was not being picked up in the current healthcare system and and there was no consistent process to follow up these warning signs.

Lee also said: "Neither he nor his family were aware of the clinical significance of this increased use."

Asthma + Lung UK said poor asthma care "contributes to the 60,000 annual hospital admissions made because of asthma, and a total of 200,000 bed days per year".

Spillett said the overuse of reliever inhalers (which are usually blue) was a concern because they "treat the symptoms of asthma such as breathlessness, coughing and wheezing, but not the underlying inflammation".

She said if someone was using one more than three times a week they needed to make an urgent appointment to discuss treatment options with a healthcare professional.

The charity has said it wants to ensure everyone with asthma gets an annual review and wants clinicians to prescribe more of those inhalers that treat both asthma symptoms and inflammation.

Asthma + Lung UK said it produced a report last year that suggested only 32% of people with asthma were receiving adequate levels of care as prescribed by NICE.

That included an annual review, an inhaler check, and an asthma action plan.

The charity said it was "well known" that many people with asthma did not use their inhaler effectively.

It added: "We know that without inhaler technique guidance, a majority of patients will make one or more critical errors when using their inhaler, and that the absence of a Personalised Asthma Action Plan is linked to poor health outcomes, including a heightened risk of death."

Follow BBC Coventry & Warwickshire on BBC Sounds, Facebook, X and Instagram.