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a man asthma inhaler imageJanuary 2 2017

The British Thoracic Society has published a detailed comparison of the existing BTS/SIGN asthma guidelines and the new NICE guideline.

Published as a BMJ blog, the article points out that the BTS first produced a guideline on asthma and its management in 1990. In addition, the first collaborative guideline was published with the Scottish Intercollegiate Guideline Network (SIGN) in 2003, with regular updates since then. NICE published its guideline [NG80] ‘Asthma: diagnosis, monitoring and chronic asthma management’ in November

The BTS blog looks at the differences in approach around diagnosis and pharmacological management and considers:

  • the introduction of leukotriene receptor antagonists (LTRA) after low dose inhaled corticosteroids (ICS);
  • maintenance and reliever therapy (MART);
  • treatment beyond combined inhaler therapy;
  • some other issues in managing asthma in children.

“The BTS/SIGN guideline also provides recommendations for important aspects of asthma management that are not addressed within NICE guidelines. These include guidance on inhaler devices, the management of acute asthma attacks in both adults and children, the management of difficult asthma, guidance on asthma in adolescents, in pregnant women and on occupational factors,” say the BTS authors.

The Primary Care Respiratory Society UK has also published a briefing document outlining the similarities and differences between the two sets of guidelines, with a particular reference to primary care.

It notes that the BTS blog authors state that their article “is currently in press and BTS advises that it may be subject to minor content and format changes before publication in the February 2018 issue of Thorax.”

Links:
BMJ blog article                 
PCRS statement                  
PCRS-UK briefing document         
Today’s GP coverage of NICE asthma guideline publication              

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