HEE issues medicines management guidance for nursing associates

HEE issues medicines management guidance for nursing associates

February 23 2018 Health Education England has set out educational content expectations for...

RPS urges community pharmacists to take up free post-registration training

RPS urges community pharmacists to take up free post-registration training

February 22 2018 Community pharmacists in England are being urged to enrol on Masters level...

Which? report claims 'three in 10 pharmacies not following safety guidelines'

Which? report claims 'three in 10 pharmacies not following safety guidelines'

  February 20 2018 A covert study of pharmacies has claimed that some pharmacies are...

British Lung Foundation issues pharmacy resources

British Lung Foundation issues pharmacy resources

February 20 2018 Two new guides supporting the role of community pharmacists in helping patients...

CPPE announces patient safety learning campaign

CPPE announces patient safety learning campaign

February 19 2018 Pharmacists should be receiving educational material this week on a new patient...

  • HEE issues medicines management guidance for nursing associates

    HEE issues medicines management guidance for nursing associates

    Friday, 23 February 2018 10:14
  • RPS urges community pharmacists to take up free post-registration training

    RPS urges community pharmacists to take up free post-registration training

    Thursday, 22 February 2018 16:05
  • Which? report claims 'three in 10 pharmacies not following safety guidelines'

    Which? report claims 'three in 10 pharmacies not following safety guidelines'

    Tuesday, 20 February 2018 17:04
  • British Lung Foundation issues pharmacy resources

    British Lung Foundation issues pharmacy resources

    Tuesday, 20 February 2018 16:34
  • CPPE announces patient safety learning campaign

    CPPE announces patient safety learning campaign

    Monday, 19 February 2018 17:29

Umesh Modi is a chartered accountant, and Pamini Jatheeskumar is a chartered certified accountant at Silver Levene...
  Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead...
Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead pharmacist, Health and Wellbeing Directorate, Public Health England
More inWhite Papers  

a man asthma inhaler imageDecember 1 2017

NICE has published new guidelines on asthma addressing diagnosis, monitoring and the management of chronic asthma.

Asthma UK’s in-house GP, Dr Andrew Whittamore, has summarised the most significant changes for adults and children over the age of 5 years:

  • Diagnostic tests, as well as history taking, should be carried out before initiating pharmacotherapy, unless there is an urgent acute need for medication.
  • Diagnostic testing should normally use a combination of objective tests, such as spirometry, fractional exhaled nitric oxide (FeNO) and peak flow testing;
  • People who are not having symptoms controlled adequately by a steroid preventer inhaler alone should be offered an oral leukotriene receptor antagonist (LTRA) alongside a steroid preventer for 1-2 months to see if it makes a difference, rather than using a combination inhaler of a steroid and long acting beta agonist.

People who are already on a combination inhaler with well-controlled symptoms will continue their treatment.

For infants and young children, the approach to diagnosis and management will continue as a ‘trial of treatment’ with close monitoring.

The Royal College of Physicians has also flagged up another key recommendation, that of taking into account the possible reasons for uncontrolled asthma, before starting or adjusting medicines for asthma in adults, young people and children. These may include:

  • alternative diagnoses
  • lack of adherence
  • suboptimal inhaler technique
  • smoking (active or passive)
  • occupational exposures
  • psychosocial factors
  • seasonal or environmental factors.

Professor Mark Baker, director of the centre for guidelines at NICE, said: “We are recommending objective testing with spirometry and FeNO for most people with suspected asthma; a significant enhancement to current practice, which will take the NHS some time to implement, with additional infrastructure and training needed in primary care.”

The Primary Care Respiratory Society UK (PCRS) said it was “concerned that the new NICE guideline will create uncertainty for primary care clinicians, because in some areas they recommend a different approach to the BTS/SIGN (British Thoracic Society and Scottish Intercollegiate Guidelines Network) guideline, which has set the evidence based standard for the UK since 2003.”

However, the PCRS said it recognised “the importance of NICE’s incorporation of cost-effectiveness analysis, which is not addressed by BTS/SIGN.”

The British Thoracic Society said it contributed to NICE’s stakeholder consultation on these guidelines, and met with NICE earlier this year “for a useful exchange of views.” In addition: “BTS will issue a clinical response to the NICE Guidelines shortly, which we hope will be helpful to people with asthma, their carers and healthcare professional.”

Links:
NICE announcement      
NICE guideline [NG80] ‘Asthma: diagnosis, monitoring and chronic asthma management’. November 2017              
NICE Quality standard [QS25] ‘Asthma’. Published February 2013, updated November 2017           
PCRS statement                  
Asthma UK Dr Andrew Whittamore blog post       
RCP statement  
BTS/SIGN British guideline on the management of asthma               

Practice News

February 23 2018 Health Education England has set out educational content expectations for nursing associates who administer medicines to patients.
February 19 2018 Pharmacists should be receiving educational material this week on a new patient safety campaign from the Centre of Pharmacy Postgraduate Education. Resources have been mailed out ahead...