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See Table 1 in the Diagnostic summary section for a summary of objective test threshold levels. Diagnostic hubs . Those responsible for planning diagnostic service support to primary care (for example, clinical commissioning groups) should consider establishing asthma diagnostic hubs to achieve economies of scale and improve the practicality of implementing the recommendations in this guideline. The way to diagnose and manage asthma has changed with FeNO testing. NICE has recently published new guidance on asthma diagnosis and monitoring. The most significant change to the guidance is the introduction of FeNO testing. If you suspect asthma in an adult patient, a FeNO test should be offered. A 2017 systematic review found that FeNO has moderate diagnostic accuracy for asthma.9 In the studies considered by the NICE guideline development group (GDG), they found the FeNO showed moderate to high sensitivity and high specificity in children and young people aged 5-16 years and high sensitivity and specificity in adults, depending on the Asthma is a complex disease that can be characterized by recurring symptoms, airflow obstruction, bronchial hyper-responsiveness, and airway inflammation. As one of the most common respiratory diseases in the world today, asthma affects about 300 million peo-ple worldwide, which is expected to increase to 400 million by 2025 (Dharmage 2019 In 2016 in England and Wales alone, a shocking 1,237 people died from an asthma attack 2. On November 29 th 2017, NICE published the final guidelines on Asthma: diagnosis, monitoring and chronic NICE ASTHMA GUIDELINES 2017 (NICE) published new guidance on asthma diagnosis and monitoring BTS/SIGN British Guideline for the management of asthma, 2016, The Quality standard for asthma (NICE 2013) 2016 guideline on the management of asthma. sign.ac.uk/pdf/QRG153.pdf [AccessedDecember 2016]. Asthma is a common chronic inflammatory condition of the airways, associated with airway hyperresponsiveness and variable airflow obstruction. The most frequent symptoms of asthma are cough, wheeze, chest tightness, and breathlessness. Asthma symptoms vary over time and in intensity and can gradually or suddenly worsen, provoking an acute Both guidelines recommend that in the absence of unequivocal evidence of asthma, a diagnosis should be 'suspected' and that initiation of treatment (typically inhaled steroids) should be monitored carefully and the diagnosis reviewed if there is no objective benefit. Management of Asthma in Primary Care Adapted from the 2014 BTS/SIGN Guideline for the Management of Asthma and incorporating NICE guidance on inhaled steroids, NICE Quality Standard for asthma and the recommendations of the RCP National Review of Asthma Deaths Date of Preparation: June 2008 Modified: August 2015 Version 4.0 INTERIM GUIDANCE ON ASTHMA MANAGEMENT DURING THE COVID-19 PANDEMIC . Advise patients with asthma to continue taking their prescribed asthma medications, particularly inhaled corticosteroid (ICS) medications, and oral corticosteroids (OCS) if prescribed . Asthma medications should be continued as usual during the COVID-19 pandemic.
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