30/11/2024
Been digesting the updated guidelines & reviewing the evidence for the good, the bad & the ugly within.
A heavier focus on use of FeNO in children & adults, for management as well as diagnosis, which is a useful step. We need to find a way to get this embedded into primary care, which will no doubt need funding discussions, to make FeNO much more mainstream.
The diagnostic criteria raises some concerns for me, with elements which need a good Asthma knowledge foundation. There is a significant focus on T2 asthma, with tests to look for atopy & eosinophilia, which risks missing other phenotypes of asthma. Some of the spirometry reversibility criteria uses weak evidence in my opinion & we have stronger guidance around spirometry which could have been used.
Some big management changes & I am very happy to see the statements around pollution. The pharmacological changes in management will have a positive impact & now aligns to GINA. Many of us have been using GINA already, so this approach is not new to us, but now we need to get this normalised in clinical practice! Time to remind people living with asthma that is an upgrade to the old school approach!
This guideline covers diagnosing, monitoring and managing asthma in adults, young people and children. It 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
