Care of asthmatics on discharge from hospital: a hospital audit

The objective of this study was to audit the care of patients after discharge from hospital, following admission for acute severe asthma, using the British Thoracic Society guidelines (1) as a standard. Discharge prescriptions and questionnaires sent to patients at home were analyzed for 51 patients who had been admitted to a teaching hospital with acute severe asthma. Main outcome measures were Peak flow measurements, written instructions, prescription of steroids, and outpatient follow-up. Of the 34 patients responding to the questionnaires, 15 (44%) had no peak flow meter, 23 (68%) had no written instructions, 13 (38%) had no supply of oral steroids at home, and 32 (94%) were prescribed a beta-agonist regularly of whom 12 (35%) were not on an inhaled steroid. Four (9%) patients were not followed up as outpatients; appointments ranged from 2 to 56 days following discharge. In over 60% of asthmatic patients discharged from hospital the guidelines recommended by the British Thoracic Society were not followed. The method used is an inexpensive, efficient way of auditing hospital practice.