Asthma guidancePosted on: 1 Feb 2019
Confusion in primary care persists as to which asthma guidance to follow.
BTS/SIGN published guidance for the management of asthma in 2016. Following in 2017, NICE published its guidance ‘Asthma: diagnosis, monitoring and chronic asthma management’. Discrepancies between the guidelines have the potential to introduce uncertainty for clinicians and inconsistencies in the care of individual patients.
Resolution has been provided in ‘Asthma Guidelines in Practice – a PCRS-UK Consensus’, written by Luke Daines and various GP and nurse colleagues. The Consensus supports the BTS/SIGN position on diagnosis, and reasserts the primary importance of good clinical method and regular assessments. In line with NICE, it recommends investigating the creation of diagnostic hubs to provide diagnostic services not currently available in primary care.
As regards treatment, it accepts the cost-benefit rationale for leukotriene receptor antagonists as add-on treatment after low-dose inhaled corticosteroids.
The authors call for collaboration between NICE and BTS/SIGN in developing a single asthma guideline. This view is further elaborated in an article in the BMJ entitled ‘Conflicting asthma guidelines cause confusion in primary care’.
Also, watch senior respiratory clinicians discuss the issues.