For the first time, the British Thoracic Society (BTS),
National Institute for Health and Care Excellence (NICE) and the
Scottish Intercollegiate Guidelines Network (SIGN) have
collaborated to develop a UK-wide asthma guideline
A new guideline published today (Wednesday, 27 November)
recommends chronic asthma should be diagnosed by healthcare
professionals when people first show symptoms by using simple
tests.
The guideline also says healthcare professionals should always
prescribe maintenance or combination treatments, which prevent
and relieve symptoms, rather than the familiar blue
‘reliever-only' inhaler, when asthma is first diagnosed.
For the first time, the British Thoracic Society (BTS), National
Institute for Health and Care Excellence (NICE) and the Scottish
Intercollegiate Guidelines Network (SIGN) have worked together to
produce a new UK-wide joint guidance for the diagnosis and
management of chronic asthma in adults, young people and
children.
It recommends healthcare practitioners should offer a low-dose
combination of inhaled corticosteroids (ICS) and formoterol to be
taken as needed for everyone aged 12 and over with newly
diagnosed asthma to reduce inflammation as well as relieve
symptoms.
It recommends not prescribing short-acting beta2 agonists (SABA),
the most widely used blue ‘reliever' inhaler/medication, without
inhaled corticosteroids, to anyone diagnosed with asthma.
The independent guideline committee looked at evidence which
showed using the combined ICS and formoterol inhalers when
required led to people suffering fewer severe asthma attacks.
As part of the final guideline publication BTS, NICE and SIGN
have also developed a new digital resource which will act as a
‘one stop shop' online. The digital asthma pathway links to
tools, resources and information, all stored in a central hub,
accessible from each organisation's website.
The pathway has been designed to support health professionals in
making accurate diagnoses, promoting good practice, and providing
effective, personalised treatment to control and prevent acute
asthma attacks.
The
asthma pathway includes existing
BTS/SIGN guidance on management of acute asthma,
non-pharmacological management, and occupational asthma. Other
resources include a joint patient decision aid
on asthma inhalers and climate change, all asthma drugs
and treatments recommended by NICE and advice from the Scottish
Medicines Consortium.
Asthma is a common lung condition, where people have breathing
difficulties. Symptoms include breathlessness, coughing, wheezing
and tightness in the chest. In the UK, around 5.4 million people
have asthma, which is about eight in every 100 people.
Dr Paul Walker, BTS Chair, said: "The British
Thoracic Society and respiratory professionals welcome the new
asthma guideline and the impact it will have on asthma care
across the whole United Kingdom. The change in diagnostic
investigations will simplify diagnostic processes and help with
current diagnostic delays for adults, children and young people.
The treatment changes represent a true pivot in the principles of
asthma care and will contribute to improved outcomes. The society
wishes to thank the very many people who have worked to deliver
this guideline. This is only the start of much hard work in
dissemination, education and implementation but this will
ultimately deliver better care for people with asthma.
Professor Jonathan Benger, chief medical officer and
interim director of the Centre for Guidelines at NICE,
said: “I am delighted BTS, NICE and
SIGN have collaborated to develop this useful and useable
guideline. It aims to help ease the pressure on the health
service by reducing hospital admissions due to asthma and
lowering the use of less effective monitoring tests.
“Having one clear set of national asthma guidelines is vital to
ensure people receive consistent and effective asthma care across
the health service, so people across the UK receive the right
diagnosis and treatment for them.”
The guideline also includes new recommendations for the diagnosis
of asthma in both adults and children, including the use of FeNO
(a simple breath test) and measurement of eosinophil cells in the
blood as well as traditional tests like spirometry or peak flow
measurements.
Professor Angela Timoney, chair of the SIGN Council,
said: “I am very pleased for clinicians and patients
across the UK that our three organisations have worked together
to produce a guideline that will impact on diagnosis and
treatment of patients with asthma. The recommendations are based
on rigorous appraisal of the evidence and will change and improve
asthma care.
You view the asthma pathway now and read
the full asthma: diagnosis, monitoring
and chronic asthma management guideline on both the NICE
website and the SIGN website.
