Patients with severe asthma, a condition that cannot be managed in primary care, are not getting referred for treatment that could save their lives, according to a new report from Asthma UK.

The condition known as difficult and severe asthma is resistant to usual treatments and requires high dose steroid tablets that have serious side effects. People with difficult and severe asthma require management in secondary and tertiary care (local or regional hospitals) and may be eligible for new drugs known as monoclonal antibodies (mAbs). However, access to this crucial care is uneven.

In the report, Living in limbo: The scale of unmet need in difficult and severe asthma, the charity analysed data including health surveys, hospital appointments and prescribing records to find out the scale of the unmet need for a group at particular risk of life-threatening asthma attacks.

It found that only 18% of adults with possible difficult and severe asthma are getting referred for specialist treatment in line with clinical guidelines. For the first time, it was also able to estimate that about 48,000 people are currently missing out on these new, life-changing treatments.

Asthma UK said that people with the most devastating form of the condition are not receiving the care they need, and this needs to change.

The report comes just one week after the charity announced that deaths from asthma attacks are at the highest point for a decade and have increased by more than 33% over the last ten years.

Awareness needed for clinicians treating severe asthma

The report recommends the development of clear referral guidelines coupled with raised awareness for clinicians along with a review of capacity in secondary and tertiary care based on the unmet need highlighted in this report and the commissioning of new asthma services as required.

It is also calling on appropriate access to new biologic treatments to address the unmet need outlined in this report.

Dr Samantha Walker, director of policy and research at Asthma UK said: “For the first time we have the full picture of the scale of the unmet need in severe asthma care. We want healthcare professionals to take asthma seriously and refer suspected severe asthma patients more quickly, as they are have the highest risk of dying from an asthma attack.”