sign101

Recommendations

Info

British Guideline on the MAnAGeMent of AsthMA 110 PATIENT EDUCATION, SELF MANAGEMENT AND COMPLIANCE Dr Hilary Pinnock (Chair) General Practitioner, Whitstable Medical Practice, Kent Dr Graham Douglas Consultant Respiratory Physician, Aberdeen Royal Infirmary Mrs Erica Evans Care Development Manager, Asthma UK, London Dr Liesl Osman Senior Research Fellow, Aberdeen Royal Infimary SPECIAL SITUATIONS Difficult asthma Dr Liam Heaney Senior Lecturer in Respiratory Medicine, (Chair) Queens University, Belfast Dr Chris Brightling Senior Clinical Research Fellow, Glenfield Hospital, Leicester Dr Andrew Menzies-Gow Consultant Respiratory Physician, Royal Brompton Hospital, London Dr Brian Smith South Australian State President of the Thoracic Society of Australia Dr Nicola Wilson Honorary Consultant Paediatrician, Royal Brompton Hospital, London Asthma in pregnancy Dr Cathy Nelson-Piercy Consultant Obstetric Physician, (Chair) St Thomas’ Hospital, London Dr Bernard Higgins Consultant Respiratory Physician, Freeman Hospital, Newcastle upon Tyne Dr Laura Price Research Fellow, Imperial College, London Occupational asthma Dr Sherwood Burge Consultant Respiratory Physician, Birmingham (Chair) Heartlands Hospital Professor Anthony Frew Professor of Allergy and Respiratory Medicine, Brighton General Hospital Asthma in adolescents Dr James Paton Reader and Honorary Consultant Paediatrician, Royal (Chair) Hospital for Sick Children, Glasgow Miss Ann McMurray Asthma Nurse Specialist, Royal Hospital for Sick Children, Dr Mitesh Patel Medical Research Fellow, Medical Research Institute of New Zealand Mrs Iona Paterson Cystic Fibrosis Pharmacist, Gartnavel General Hospital, Glasgow Dr Donald Payne Paediatrician, Princess Margaret Hospital, Western Australia Miss Cher Piddock Clinical Lead, Care Development Team Asthma UK
11.4 disseMinAtion GrouP Mrs Sheila Edwards Chief Executive, British Thoracic Society, London Ms Monica Fletcher Chief Executive, Education for Health, Warwick Dr Bernard Higgins Consultant Respiratory Physician, Freeman Hospital, Newcastle upon Tyne Dr Steve Holmes General Practitioner and Chair, General Practice Airways Group, Somerset Dr Roberta James* Acting Programme Director, SIGN Dr James Paton Reader and Honorary Consultant Paediatrician, Royal Hospital for Sick Children, Glasgow Dr Hilary Pinnock General Practitioner, Whitstable Medical Practice, Kent Mrs Sally Welham Deputy Chief Executive, British Thoracic Society, London 11.5 systeMAtiC literAture revieW The evidence base for this guideline built on the reviews carried out for the original (2003) version of the guideline and subsequent updates. All searches covered the Cochrane Library, Embase, and Medline. See Annex 1 for details of the time period covered for each topic. A copy of the search narrative, including listings of strategies, is available on the SIGN website as part of the supporting material for this guideline. 11.6 ConsultAtion And Peer revieW 11.6.1 CONSULTATION The most recent changes to this guideline were presented for discussion in draft form at the Summer Meeting of the British Thoracic Society in June 2010. The draft guideline was also available on the SIGN and BTS websites for a limited period at this stage to allow those unable to attend the meeting to contribute to the development of the guideline. 11.6.2 SPECIALIST REvIEWERS 11 develoPMent of the Guideline The guideline was also reviewed in draft form by the following independent expert referees, who were asked to comment primarily on the comprehensiveness and accuracy of interpretation of the evidence base supporting the recommendations in the guideline. SIGN and the BTS are very grateful to all of these experts for their contribution to the guideline. Dr David A R Boldy Consultant Respiratory Physician, Pilgrim Hospital, Boston, Lincolnshire Dr Patrick Cadigan Registrar of the Royal College of Physicians, London Dr Kevin Gruffydd-Jones Respiratory Lead, Royal College of General Practitioners, Joint Policy Lead, General Practice Airways Group and General Practitioner, Box Surgery, Wiltshire Dr Erica Haines Asthma Clinical Lead, Education for Health, Warwick Mr Kevin Holton Head of Respiratory Programme, Department of Health, London Dr Jeremy Hull Guidelines Officer, British Paediatric Respiratory Society, London Dr Duncan Keeley General Practitioner, Thame Health Centre, Oxon 111
Page 1 and 2:
101 British Guideline on the Manage
Page 3 and 4:
British Thoracic Society Scottish I
Page 5 and 6:
Revised 2011 Revised 2011 Revised 2
Page 7 and 8:
1 introduction 1.1 the need for A G
Page 9 and 10:
1.3.1 PATIENT vERSION Patient versi
Page 11 and 12:
Table 1: Clinical features that inc
Page 13 and 14:
Case detection studies have used sy
Page 15 and 16:
2.1.6 CHILDREN WITH AN INTERMEDIATE
Page 17 and 18:
2.3 suMMAry focus the initial asses
Page 19 and 20:
2.4 diAGnosis in Adults The diagnos
Page 21 and 22:
2.4.1 FURTHER INvESTIGATION OF PATI
Page 23 and 24:
Table 6: Differential diagnosis of
Page 25 and 26:
2.5.1 TREATMENT TRIALS AND REvERSIB
Page 27 and 28:
A small prospective observational s
Page 29 and 30:
Table 8: Summary of tools that can
Page 31 and 32:
Measurement Methodology Asthma Cont
Page 33 and 34:
Measurement Methodology Eosinophil
Page 35 and 36:
3.1.2 FOOD ALLERGEN AvOIDANCE Sensi
Page 37 and 38:
The limited data on antenatal or ea
Page 39 and 40:
3.3.2 AIR POLLUTION Challenge studi
Page 41 and 42:
3.5 CoMPleMentAry And AlternAtive M
Page 43 and 44:
Revised 2011 4 Pharmacological mana
Page 45 and 46:
Table 8b: Equivalent doses of inhal
Page 47 and 48:
4.2.3 SAFETy OF INHALED STEROIDS Th
Page 49 and 50:
4.3.2 ADD-ON THERAPy Options for ad
Page 51 and 52:
4.4 steP 4: Poor Control on ModerAt
Page 53 and 54:
4 PhArMAColoGiCAl MAnAGeMent Colchi
Page 55 and 56:
MOVE UP TO IMPROVE CONTROL AS NEEDE
Page 57 and 58:
4.6 stePPinG doWn Stepping down the
Page 59 and 60:
4.7.5 ASPIRIN-INTOLERANT ASTHMA The
Page 61 and 62:
5.3 inhAled steroids for stABle Ast
Page 63 and 64:
Revised 2009 6 Management of acute
Page 65 and 66: Patients with brittle or difficult
Page 67 and 68: Table 11: Initial assessment - the
Page 69 and 70: In acute asthma without life threat
Page 71 and 72: 6.3.8 ANTIBIOTICS 6.3.9 HELIOx When
Page 73 and 74: 6.6.2 PATIENT EDUCATION Following d
Page 75 and 76: 6.7.2 PULSE OxIMETRy 6.7.3 PEF Accu
Page 77 and 78: Frequent doses up to every 20-30 mi
Page 79 and 80: 6.9.3 Iv MAGNESIUM SULPHATE Intrave
Page 81 and 82: New 2011 7 special situations 7.1 A
Page 83 and 84: Gender During adolescence there is
Page 85 and 86: Complementary and alternative medic
Page 87 and 88: Table 13: Recommendations for organ
Page 89 and 90: 7.2 diffiCult AsthMA 7.2.1 DEFINING
Page 91 and 92: Revised 2009 Controlled studies usi
Page 93 and 94: Continuous fetal monitoring should
Page 95 and 96: C use steroid tablets as normal whe
Page 97 and 98: 7.9.2 AT-RISK POPULATIONS Several h
Page 99 and 100: 7.9.6 SPECIFIC BRONCHIAL PROvOCATIO
Page 101 and 102: Asthma clinics in primary care may
Page 103 and 104: A 8.3 Audit discharge from hospital
Page 105 and 106: 9 Patient education and self manage
Page 107 and 108: 9.2.1 COMPLIANCE WITH MONITORING AN
Page 109 and 110: Table 15. Summary of the key compon
Page 111 and 112: 8. What role does patient preferenc
Page 113 and 114: Dr James Paton* Reader and Honorary
Page 115: INHALER DEvICES Dr John White (Chai
Page 119 and 120: Abbreviations ABG arterial blood ga
Page 121 and 122: Annex 2 Management of acute severe
Page 123 and 124: Annex 4 Features of acute severe as
Page 125 and 126: Annex 6 Consider prednisolone 20 mg
Page 127 and 128: Annex 8 Management of acute asthma
Page 129 and 130: Annex 10 PEF (l/min) EU Scale 680 6
Page 131 and 132: Annex 11 (contd) Annexes 125
Page 133 and 134: 56. Abu-Hasan M, Tannous B, Weinber
Page 135 and 136: 156. Lodrup Carlsen KC, Carlsen KH,
Page 137 and 138: 256. Malmstrom M, Ahlner J, Carlsso
Page 139 and 140: 352. Brocklebank D, Ram F, Wright J
Page 141 and 142: 456. McDowell KM, Chatburn RL, Myer
Page 143 and 144: 562. McDonald JC, Keynes HL, Meredi
Page 145 and 146: 668. Enright PL, McClelland RL, New
Page 147 and 148: 767. Berger W. Budesonide inhalatio
Page 149 and 150: 862. Pedroletti C, Lundahl J, Alvin
Page 151: ISBN 978 1 905813 28 5 British Thor
show all

sign101

Create successful ePaper yourself

Delete template?

Save as template?