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At the heart of general practice since 1960

Evidence-based asthma care

Map of Medicine analyses the evidence on asthma care and suggests interventions to achieve productivity improvements while maintaining quality and safety.

http://www.pulsetoday.co.uk/practical-commissioningl

 

  • Ensure the least costly inhaled steroid therapy device is prescribed.1,2 NICE guidance on inhaled steroids for the treatment of chronic asthma in children younger than 12 years, published in 2007, concluded that there was no difference in effectiveness between different steroids, either at low or high doses.1 It is recommended the least costly device should be used.1 NICE guidance on steroids for chronic asthma in adults and children aged 12 years and older, published in 2008, concluded that there was no difference in effectiveness between different inhaled steroids, either at low or high doses.2
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  • Ensure the least costly single combination device, rather than separate devices, is prescribed when introducing a long-acting ß-agonist (LABA) for patients already taking inhaled steroid therapy.1,2 NICE guidance on inhaled steroids for the treatment of chronic asthma in children under 12 years, published in 2007, concluded that treatment with an inhaled steroid plus a LABA in a single device was at least as effective as using the same therapies in separate devices.1 The use of a single combination device is cost-saving.1 For the budesonide/formoterol combination, yearly savings range from £35 to £190 per patient under 12 years of age, while yearly savings for fluticasone/salmeterol range from £132 to £274.1 NICE guidance on inhaled steroids for the treatment of chronic asthma in adults and in children age 12 years and older, published in 2008, concluded that treatment with an inhaled steroid plus a LABA in a single combination device was at least as clinically effective as the same therapies in separate devices.2 The use of a single combination device is cost-saving compared with using separate devices.2 For the budesonide/formoterol combination device, yearly savings range from £36 to £227 per patient, while yearly savings for the fluticasone/ salmeterol device range from £39 to £185.1
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    For further information go to www.mapofmedicine.com/solution/productivityconsiderations

    Key dates

    The Map of Medicine systematically monitors medical literature for the latest productivity interventions and will update this document as new evidence emerges. Last update: 28-Jan-2011 Version: 1.0

    Methodology

    The productivity considerations presented in this document are relevant to the UK.

    They were identified by systematically searching for and appraising productivity evidence from multiple sources, including NICE guidance, health economic databases and Zynx Health (a sister company of Map of Medicine).

    A productivity message explicitly states interventions that can reduce the cost of care, while maintaining or improving patient outcomes.

    Actions that are believed to lead to improved productivity, but lack unequivocal clinical or economic evidence, are not included.

    Some productivity considerations are informed by more recent evidence than that included in relevant national guidelines. The document has been peer reviewed.

    References

    1 National Institute for Health and Clinical Excellence (NICE). Inhaled corticosteroids for the treatment of chronic asthma in children under the age of 12 years. Technology Appraisal Guidance 131. London, 2007

    2 National Institute for Health and Clinical Excellence (NICE). Inhaled corticosteroids for the treatment of chronic asthma in adults and in children aged 12 years and over. Technology Appraisal Guidance 138. London, 2008

    Disclaimer

    This document is not to be substituted for a healthcare professional's advice

    © 2011 Map of Medicine Ltd Asthma 1/1

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