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Controversial question! Are asthma reviews really useful or just a box ticking exercise?

Pipsqueak77 profile image
33 Replies

Hi All

I ask this question because I don’t have a very pro-active GP surgery or ‘engaged’ asthma nurse! So every year I get this invite and most times I ignore it because on the odd occasion I have attended I feel ignored and let down with no obvious positive outcome. My knowledge of my own condition seems undermined by random unnecessary questionnaires, demonstrations and lectures (the results of which I have no idea!) to ultimately be told ‘ if you have problems - go and speak to your hospital cons I can’t do anything about it!’

I understand that not everyone has this kind of experience but many do.. and I just can’t help wondering what is the point?

Just wondered how common this is?

Any thoughts??

Thanks - all stay safe 😊👍

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33 Replies
KnPoa profile image
KnPoa

I get what you mean. My gp now carries them as out as an ‘online questionnaire’’. So there is no contact with an actual medical staff member. If needs, you can go in. I see my doctor quite a lot about my asthma and he never puts what I actually say on the form and then signs off my as my asthma is controlled and it’s not.

Gareth57 profile image
Gareth57

For me it is a box ticking exercise, I don’t recall how many reviews I have been to but only 1 was worth it for me and 1 the nurse was giving me incorrect information because he didn’t know what my inhalers were, but I have to go or they stop the repeat prescription 😡

Pipsqueak77 profile image
Pipsqueak77 in reply to Gareth57

Hi Gareth57

It’s awful that they stop your meds if you don’t go... 😐 can they do that??

I just feel that because I attend a hospital clinic they seem to have washed their hands of me and don’t seem to worry what I ask for on repeat.🤷‍♂️

This is fine but why ask me to attend ?

Thanks for your input..

😊👍

twinkly29 profile image
twinkly29 in reply to Pipsqueak77

Mine is kind of like that - but I don't mind as they're on the same page. Plus they can learn about doesn't fit the box asthma 😂 But if they're not clued up in "ok we can't do anything but we're keeping an eye and are here if we can help" way then that's supportive at least. Passing the buck doesn't help does it.... especially if where the buck is passed to isn't wonderful either!

EmmaF91 profile image
EmmaF91Community Ambassador

Tick-boxing for me and even the person doing it says so 😅. They aren’t going to change my meds as I’m hospital lead, and the hosp frequently check technique (to the point hosp ANs have said they are tick-boxing too). However, they do sometimes suggest things for me to suggest, and like Gareth, if I don’t go it can be a pain getting meds renewed. Mine usually turn into a catch up chat 😂

Melanie1989 profile image
Melanie1989

Tick - boxing for me! I no longer have asthma reviews since being under consultant care. When I check my online records the G.P has already filled it in without me 😂

The only time I get asked about my asthma is in hospital. The consultant appointments aren't much better, my most recent one lasted 4 minutes! Which was pointless as the only thing he did was prescribe a steroid nasal spray, and said that should sort your asthma out.. I have been brittle/severe for 3 years so doubtful 😂

I get what you mean about not caring about repeats, I requested steroids every 3 weeks and 2 inhalers a month for half a year.. No one thought to check i was o.k!

Pipsqueak77 profile image
Pipsqueak77 in reply to Melanie1989

Hi Melanie1989

Thanks for your reply.. I ditto everything you’ve said!! 👍However I am glad I am not the only one ( that’s no help to you tho - sorry!)😬

Just seems this is such a problem... why is there no continuity in asthma care?

I just can’t help but think the money for these wasted reviews would be better spent trying to engage/inform asthmatics in other ways??

Thanks again and take care

😊👍

Fruitandnutcase profile image
Fruitandnutcase

I agree with what you say. It’s a box ticking exercise. Different asthma nurses have different opinions on everything.

So far I’ve been told always carry a blue inhaler even if you don’t use it - well that probably makes sense. Even though when I use my brown one twice a day I have never in over twenty five years used my blue one.

I was only given a spacer about ten years ago. I was only given a peak flow meter within the last 7-8 years and only because I asked for one. Up until then I had been asked about my peak flow.

In recent years we’ve discussed my peak flow. I was told that it should be better than it was - I got home looked up charts for age, height etc and discovered my results were really pretty good!

Think it was the same nurse who changed my spacer for one that I was supposed to breath in and out, in and out - I felt I was hyperventilating.

I once admitted that I only used my inhaler when I needed to - then I used it as directed but no that nurse told me I needed to use it every day to ‘prime’ my lungs. OK. I do that now.

I explained that to the next nurse I saw and she gave me the same sort of spacer I had always used.

The most recent nurse told me I didn’t need to use it all the time if I knew specific things made my chest tight - but then she decided I should be booked in for spirometry.

Bear in mind that I only see an asthma nurse once a year and I trundle along quite nicely on my own.

I find that when I go to see them I feel as if I’m being grilled by the enemy, it’s not really pleasant, I’m over 70 and to be honest it feels like they think I’m a doddery old fool who doesn’t know what she is doing and they are trying to catch me out.

Nowadays I find it’s more of a worry seeing them and I’d rather not bother.

I just assume they get paid for seeing me every year - like some sort of bounty on my head. But considering you can feel really ill and not be able to get an appointment at our surgery being grilled by an asthma nurse I don’t know and am unlikely to see again just irritates me. Cynical I know.

Pipsqueak77 profile image
Pipsqueak77 in reply to Fruitandnutcase

Hi Fruitandnutcase

Thanks for the input..😊

I am sorry you have so much trouble but sadly I’m not surprised..🙁

This is exactly the problem ( seemingly) for so many people. I just don’t understand why it is not highlighted by the ‘ powers that be’ and re-evaluated??🤔

Take care and stay safe😊

Anniecath profile image
Anniecath in reply to Fruitandnutcase

Hi, I feel exactly the same. I feel under attack, under pressure to change medication etc etc. The whole experience feels counter productive and I am always left with the feeling that I probably know more about the disease than the medical staff.

Itswonderful profile image
Itswonderful in reply to Fruitandnutcase

I get you completely! Especially the being “grilled” bit and the AN seemingly trying to “catch you out”. It’s horrible! I mentioned to a different AN only last week that when I saw her colleague, I was made to feel I shouldn’t be asking for ventolin inhalers because she counted up how many I’d had in they year at my asthma review. Of course I should have anticipated the reply which was “she was trying to ascertain how many you had used because that is a sign that you may not be controlled “. I replied that I was made to feel is had too many and it was too expensive and it made me feel that I shouldn’t ask. I think I have upset them because after coughing to choking point for nearly two years I made a private appointment with a specialist. I only did it because I couldn’t face another winter of a cough and difficulty breathing like I had done. Yes I think asthma reviews are mainly a tick box exercise these days but also a chance for that particular AN to save some money. I will say it didn’t used to be before an excellent AN left. She had asthma herself and had worked for the British Lung Foundation. She was a huge loss to the surgery’s asthma patients. So yes, I hear you! The question is, what do we do about it?

Pipsqueak77 profile image
Pipsqueak77 in reply to Itswonderful

Hi Itswonderful

Thanks for your reply...😊

Yes! You are spot on...‘What do we do about it?’ I think that is one of the reasons I posted about this... because I am hoping that ‘someone’ will take note of the issues.. and look at it a bit closer!?

Who knows but most of us have been in your position and it’s not acceptable. People will not attend reviews if they are made to feel upset or a burden.

Stay safe 😊

Itswonderful profile image
Itswonderful in reply to Pipsqueak77

Who would be looking at these questions and posts in the detail needed to pick up our concerns (you have a significant response so it appears to be common practice or at least a common way we are made to feel) with the know of how to bring concerns to the attention of the right people?

Pipsqueak77 profile image
Pipsqueak77 in reply to Itswonderful

Hi Itswonderful

I don’t really know... 🤷‍♂️ Just a vain hope??😬

However Asthma UK maybe???

I know someone polices these boards!!

Thanks!!👍😊

twinkly29 profile image
twinkly29

Another box ticking for me GP says so. Am happy to do it on that premis but they can't change anything for me so I'm glad they don't!

But for many people they are needed (if done by a nurse who is trained in asthma!) and if they were more regular, even by phone, then maybe primary asthma care would be better and few escalations needed? Maybe!

Lysistrata profile image
LysistrataAdministratorCommunity Ambassador

I've never had one in 7 years at this GP - not with the asthma nurse anyway, though the GP has sometimes filled in the boxes if I'm seeing them anyway. They used to agree it was pointless for me because they couldn't do anything and left it to the hospital. This year they decided I should have one then lockdown happened. Now they're again saying they want to do one, but told me the day after I was already there gahh and I cba to book it given it isn't much help. Even the hospital can't do much anyway so it doesn't feel high on my priority list.

I do think it ought to be a lot better for people who are under GP care only. Although I don't need it myself, I am deeply unimpressed that my GP surgery seems to get the HCA to do them most of the time. I'm not dissing HCAs but that to me just reinforces that they see it as a computer box-ticking exercise because HCAs are not trained to that level.

I think it should be done by a properly trained nurse or GP, NOT just someone who has been designated 'the asthma nurse' but not trained, or someone who doesn't know about asthma and fills in a form. I remember my mum telling me about what the GP surgery did for me as a child with asthma and I was really impressed in hindsight - it was all the correct care done by people who actually knew about asthma, and it's probably at least part of the reason my asthma was never a problem back then.

If the only person you see is at your GP, they need to be able to pick up and sort problems early. As Twinkly says, maybe if these reviews weren't seen as such a tick-box exercise even for people who need them and don't get other input, perhaps we would have better stats for asthma attacks and mortality than we do in the UK.

Pipsqueak77 profile image
Pipsqueak77 in reply to Lysistrata

Hi Lysistrata

Yep - couldn’t agree more!👍

But no one listens.. 😐

I am still hopeful to hear from someone with positive feed back on these reviews🤞

Thanks!

Lysistrata profile image
LysistrataAdministratorCommunity Ambassador in reply to Pipsqueak77

Lol well I have very positive feedback for a surgery in Yorkshire in 1992-1993 and one in Somerset 1993-1998...not much help now!

Pipsqueak77 profile image
Pipsqueak77 in reply to Lysistrata

😂😂 not really.. but good to know there were some!!

Anniecath profile image
Anniecath in reply to Pipsqueak77

I was with a practice in the NW from about mid '80's to 2010. It was an excellent surgery I had an excellent GP who listened and always gave me time to look up alternative suggestions for treatment and to think it through. I also had a FULLY QUALIFIED asthma nurse, not a general practitioner or nurse with an interest in the disease, who always,always explained thoroughly if and why she was recommending a change in meds./routine. I trusted both GP and asthma nurse with my LIFE. Since moving to west Cornwall I have been under constant pressure to change meds. On my 3rd GP practice as a result.

Anniecath profile image
Anniecath in reply to Lysistrata

Agree with everything you have said. So frustrating !!

watergazer profile image
watergazer

Used to have a nurse at our GPS who was good but sadly she’s gone either on long term sick leave or just left now. This years review was supposed to be by phone but I went to the surgery as they messed up details. Saw the HCA who doesn’t have much idea x

Louloubella70 profile image
Louloubella70

I recently attended my asthma review, the nurse listened to how I've been and immediately passed me over to the Dr. He told me my asthma is uncontrolled and he prescribed a high dose inhaler along with medication for my allergies, I can't fault the surgery, I even have a follow up appointment a week later.

If I hadn't gone for my review I would have just struggled on uncontrolled. He was very clear that asthma kills and I need to get it controlled. So my advice is attend your review even if you feel its a waste of time 🙂

Pipsqueak77 profile image
Pipsqueak77 in reply to Louloubella70

Hi Louloubella70

Thanks for your reply...👍

It’s great to hear that there are some GP practices who are pro- active and organised and I’m very glad that they sorted your asthma.

Sadly (as you can see from others posts) they are in the minority and not everyone appears to have access to such good asthma care. It seems to be a lottery which considering there are clear guidelines for asthma care/reviews is alarming.

I hope your surgery continue to provide you with excellent care - hold onto them!!

Take care 😊👍

Itswonderful profile image
Itswonderful in reply to Louloubella70

Good news to hear that you feel your reviews are helpful.

I think they should be a good, positive experience for me because I only have GP input, and I always want to get as much input and information and support as possible to help me manage my asthma, however I find they do just turn out to be a box ticking exercise... my practice merged a few years back which obviously means a higher number of staff, so I have yet to speak to the same ‘asthma nurse’ twice.. in some ways this can be helpful, as different people have different experiences and different ideas and things to help and advise, but sometimes I am left being told conflicting things and being confused 🤷 My peak flow best is higher than predicted, and trying to get this through to some GPs and nurses can be a nightmare, even though they I show them my asthma plan and peak flow chart, and they can see my peak flow results taken at the surgery on my medical records which shows my best peak flow! The one good thing I have found with my surgery and the reviews is that they’ve always given me a new, updated asthma plan which I find a great tool to help me keep in control of my asthma.. although last year I had to alter the peak flow boundaries for each part of my plan because the numbers my nurse had put in was too low! X

ninelives profile image
ninelives

Same here.

New GP "can't help you with that"(asthma).

Hospital review appointment say "oh contact your GP "for asthma plan.

Most of the time feel like a veritable ping pong ball!

Pipsqueak77 profile image
Pipsqueak77 in reply to ninelives

Hi ninelives

😂 thanks for reply..

Yes- exactly the problem a lot of asthmatics face. However at least we are ‘lucky?’ to have a hospital clinic to bounce too. I really feel for others who only have these yearly reviews to rely on..🤔

Stay safe👍😊

Norfolkcatlady profile image
Norfolkcatlady

So sorry you've all had such negative experiences of asthma checks. I have asthma reviews with my asthma nurse every 3 months and I have to say it's always been a really positive experience. She knows me and my asthma well and, although we have to go through a tick box questionnaire, she always offers good advise and updates my asthma plan if it needs to be.

Pipsqueak77 profile image
Pipsqueak77 in reply to Norfolkcatlady

Hi Norfolkcatlady

It’s good to hear that you are well looked after by your surgery nurse. That’s how it should be... and nice to hear positive feedback.😊

Appt every three months!!? That’s something most of us could only dream of!!

Take care 👍

Norfolkcatlady profile image
Norfolkcatlady

I'm shocked! Just assumed every surgery was like that. My asthma's been bad the last 3 weeks and one of the asthma nurses rings regularly to see how I getting on. Can't fault them.

You take care too 😊

Laurenhulk90 profile image
Laurenhulk90

I was due for my very first asthma review yesterday, the call was from a pharmacist - so i was a little confused as i was told it would be with an asthma nurse. Anyway.. because my asthma is so uncontrolled she didnt complete the review as i would have loads of 'red flags' which means she would have to change all my medication. She told me to increase my steroids back to 40mg from 30mg and said to wait for my call with the Respiratory team at the hospital next week as they are the 'experts'.

MIND BLOWN!

Pipsqueak77 profile image
Pipsqueak77 in reply to Laurenhulk90

Hi Laurehulk90

Don’t really know what to say to that....😬😬??!!

Thanks for sharing.. and take care😊

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