Waterstorm
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I'm a little confused with the current asthma guidelines. I've been doing passmedicine and it talks about the latest BTS guidelines and says that everyone diagnosed must be started on a low dose inhaled corticosteroid. Is that correct? I've never seen that in practice - and people continue to use the stepped approach of started on salbutamol. However passmedicine seems adamant that this would be the wrong thing to do!
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Ghotay
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Yup, those are the new guidelines. Salbutamol and low-dose ICS for everyone. And technically they're not 'steps' any more for some reason. Look up the BTS guideline summary document, it's pretty clear.


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nexttime
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It was a new guideline in November 2016 - that's why you haven't seen it in practice yet.
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JOO93
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(Original post by Waterstorm)
I'm a little confused with the current asthma guidelines. I've been doing passmedicine and it talks about the latest BTS guidelines and says that everyone diagnosed must be started on a low dose inhaled corticosteroid. Is that correct? I've never seen that in practice - and people continue to use the stepped approach of started on salbutamol. However passmedicine seems adamant that this would be the wrong thing to do!
New guidelines, Salbutamol and Inhaled corticosteroids for new diagnoses of asthma, I've started seeing it in practice.
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Waterstorm
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https://www.brit-thoracic.org.uk/doc...uideline-2016/

That is the full guidelines, could anyone take a moment to point out to me where it says this? The drug treatments are from page 64. I literally can't see where it says everyone should be started on steroids. It's more of consider it if they need it. Even the quick reference guide only says to consider doing it while all of the other drugs are more of a 'definitely give this'.
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ForestCat
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(Original post by Waterstorm)
https://www.brit-thoracic.org.uk/doc...uideline-2016/

That is the full guidelines, could anyone take a moment to point out to me where it says this? The drug treatments are from page 64. I literally can't see where it says everyone should be started on steroids. It's more of consider it if they need it. Even the quick reference guide only says to consider doing it while all of the other drugs are more of a 'definitely give this'.
Page 24 and 25. Suspected asthma start a six week trial of ICS.


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BlindingLight
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Main difference is starting of ICS earlier, without 'stepping up'.
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prospectivemed56
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I went to the asthma nurse for a new salbutamol inhaler last week and had a 50 mcg qvar forced on me because 'everyone should be on it now', despite no new symptoms. So it definitely seems to be trickling down.

Amusingly, at my old GP last year, I was told in no uncertain terms that I should wean myself off the ICS inhalers because everything was very well controlled and (quite emphatically) how expensive they were!
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