Are β-blockers ever safe in asthma?

Abstract

Aim: To audit an adverse event in an asthmatic patient, namely, the prescription of a β-blocker. Method: Significant event auditing, and Medline and EMBASE/Excerpta Medica literature searches, Results: Fourteen asthmatics (3.3% of the asthmatics on the practice list) were identified as ever having received a β-blocker. In all cases the history of asthma pre-dated the prescription of the β-blocker. These data and results of the literature search lead to discussion of the medicolegal implications of the event and possible changes to future management. Conclusions: A significant event audit can provide an appropriate forum for reviewing care of an asthmatic patient. β-blockers are still prescribed for asthmatics despite the well known hazards, and the incidence of this is probably under-reported. The literature suggests that no β-blocker can be safely started in an asthmatic patient in general practice.