PCRS-UK has published a consensus statement on key aspects of the diagnosis, management and monitoring of asthma to provide clarity for primary care clinicians faced with conflicting national guidelines1
Asthma Guidelines in Practice - A PCRS-UK Consensus sets out a concise and pragmatic view of the key issues raised by the recommendations of the two guidelines produced by the National Institute for Health and Care Excellence (NICE) and the British Thoracic Society/Scottish Intercollegiate Guidelines Network (SIGN). It focuses on the areas that vary substantially between the two guidelines, offering a workable solution.
The statement has been written by Dr Luke Daines (GP and Academic Clinical Fellow, University of Edinburgh), in conjunction with GP colleagues, Duncan Keeley, Kevin Gruffydd Jones, Steve Holmes and nurse colleagues, Val Gerrard and Carol Stonham. It is based on the recently published PCRS-UK briefing paper.2
- Asthma diagnosis, including the strengths and limitations of peak flow monitoring, spirometry and FeNO testing
- Diagnosis in children
- Asthma management
- Add-on therapies
- Asthma monitoring
The statement concludes that the presence of multiple guidelines for asthma care is unhelpful, creating uncertainty for clinicians and potentially leading to inconsistencies in the care of individual patients. From the outset of NICE’s proposal to develop guidelines for asthma PCRS-UK has argued for retaining a single comprehensive and regularly updated asthma guideline for the four nations of the UK.
The authors recommend: “A return to a single asthma guideline developed through the collaboration of NICE and BTS/SIGN, would allow the strengths of both organisations to be drawn upon to produce clear and consistent recommendations.”
This is a view that Duncan Keeley and PCRS-UK Chair Noel Baxter elaborate on further in an editorial published last month in the BMJ.3