Review

• Are they able to identify an increase in symptoms, were oral corticosteroids needed to be commenced or maximised, and did they reach the point where they needed to seek urgent medical review?
• Did they have a supply of prednisone at home and was it used appropriately?
• If they already have a written asthma action plan, did they use it and did it help?
• Identify the correct actions to be taken with the patient and family.
• Discuss their level of confidence managing their asthma at these times and calling for urgent care.
• Although the use of oral corticosteroids should be used with caution, identify patients who need to have medical contact before commencing prednisone and agree on how that will be conducted (e.g. phone, face to face or email). Is it the GP or some other member of their respiratory team? Discuss with the patient and make sure it is on their asthma action plan.

Check if the patient or family have questions or concerns and address them.

• Check that all the patient’s goals for the education have been achieved.
• Explain that for people with severe asthma, regular reviews with a specialist asthma centre have been shown to lead to improvements in their asthma and arrange a regular follow up review.
• Review educational components and inhaler technique at each visit as needed.
• Ensure copies of written material are given to them or online resources saved on their mobiles or laptops.
• Share outcomes with all members of the multidisciplinary team including their GP.