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GPs go forth

NICE and BTS/SIGN to produce single set of asthma guidelines

The British Thoracic Society and SIGN have said they will produce a single set of guidelines on asthma with NICE in future to alleviate 'confusion' for GPs.

BTS/SIGN have said that the three bodies will work together to produce a joint UK-wide guideline for the diagnosis and management of chronic asthma in the future.

In its new update to guidance, BTS/SIGN addressed the issue of FeNO testing, recommending that it should be used 'where available' for asthma diagnosis - which is in contrast to the NICE guidelines, which said it should be used routinely.

It also stresses the importance of assessing patients’ risk of asthma attack at every consultation and using the risk to guide treatment. It advises GPs to be aware of factors, such as comorbid allergy in children, that increase the risk of asthma attack and to look at overall asthma control and overuse of reliever inhalers to gauge risk.

Despite the differences in current guidelines, it has also been announced that BTS, SIGN and NICE will be collaborating on plans to produce a joint UK-wide guideline for the diagnosis and management of chronic asthma in the future.

The guidance will cover diagnosis and treatment and seek to clarify areas where there have previously been differences in recommendations between the three organisations.

Dr John White, respiratory consultant in York and BTS co-chair of the guideline development group, commented: ‘We clearly need consistent coordinated advice going forward. At best, having two differing sets of guidance causes a great deal of confusion and it leads to inconsistency and uncertainty, which is not what we’re trying to achieve.

‘The next asthma guidance update will be coordinated from all three bodies so that there is one body of evidence with the hope of providing an integrated pathway for managing chronic asthma – this has to be the right way forward.’

A BTS spokesperson said: ‘The SIGN/BTS update announcement is separate from the announcement of the joint guidance with NICE. We thought it prudent to announce the joint guideline at the same time as the BTS guideline update to help answer questions on what will happen in the future for guidance on chronic asthma.

‘The collaboration is really positive news as having different sets of guidance doesn’t work for all health professionals.’

Details of early progress on the joint guidance will be shared in an update session at the BTS winter meeting in December.

PLEASE NOTE: This article originally said that BTS/SIGN explicitly ruled out using FeNO testing for diagnosis of asthma in primary care, in contradiction to NICE guidelines. This was incorrect. They said use 'FeNO testing (if available)' and they ruled out the use of FeNO testing to monitor guidance - which is the same as NICE recommendations. Apologies for any confusion caused.

Readers' comments (5)

  • Phew thank goodness - I was getting all panic stricken about this unfunded diagnostic service. FFS!

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  • People are losing confidence in NICE. Some of their guidance are not pragmatic and not realistic.

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  • Vinci Ho

    Finally , alas .
    How long have we been moaning about how ‘out of touch’ are these academics, especially NICE , on this platform?
    I wonder what has changed as far as internal politics is concerned before these three finally get their heads and acts together 🤨😄?
    We want more ‘redemptions’ from NICE , dude (sorry , can’t help it after being ‘inspired’ by MojoBojo😆)

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  • NICE has been always an absolute CRAP, just once compare different countries with UK to see how miserable Brits do in the matter of guideline.

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  • Bornjovial

    NICE in concept is wonderful and is essential in a government funded health system but has lost its way over the last decade.
    To stay relevant maybe they can have standards that are divided as standard which everyone has to follow and a gold standard which recognised trail blazers can follow would be an option.

    Eg. FeNO testing is made optional where resources/circumstances allow and traditional diagnosis for the rest of us.
    If they stick to what can be implemented in every part then it will be quick race to the bottom

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