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Asthma guidance reverses advice to quadruple dose of medication

Updated guidance from National Institute for Health and Care Excellence emphasises importance of regular use rather than higher dose of inhaled corticosteroids in children and young people with asthma

Updated guidance from National Institute for Health and Care Excellence emphasises importance of regular use rather than higher dose of inhaled corticosteroids in children and young people with asthma

Picture of a medic showing a girl how to use an inhaler. Updated guidance from NICE emphasises importance of regular use rather than higher dose of inhaled corticosteroids in children and young people.
Picture: iStock

New guidance on managing asthma emphasises the importance of regular use of inhaled corticosteroids in children and young people with deteriorating asthma.

But the National Institute for Health and Care Excellence (NICE) guidance, Asthma: diagnosis, monitoring and chronic asthma management, says the aim is to help patients regain control of their symptoms through such regular use of the medication rather than increasing the dose.

Previous recommendation based on ‘limited evidence’

The updated NICE guidance for nurses and healthcare professionals row back on previous guidelines issued in 2017 which said quadrupling the dose of inhaled corticosteroids could be considered in a self-management programme for children and young people. NICE now says that recommendation was based on ‘limited evidence’.

‘For children and young people aged 5-16 years with a diagnosis of asthma, include advice in their self-management programme on contacting a healthcare professional for a review if their asthma control deteriorates,’ the new guidance states.

Restarting regular use of medication may help regain control

Healthcare professionals should explain to children and young people in the 5-16 age group who have not been taking their inhaled corticosteroids consistently that ‘restarting regular use may help them regain control of their asthma’, as the evidence for increasing inhaled corticosteroids doses to self-manage deteriorating asthma control is limited.

NICE says the guideline aims to improve the accuracy of diagnosis, help people to control their asthma and reduce the risk of asthma attacks. It does not cover managing severe asthma or acute asthma attacks.


Find out more

National Institute for Health and Care Excellence (2020) Asthma: diagnosis, monitoring and chronic asthma management


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