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GPs told to give inhaled steroids to 600,000 mild asthmatics

GP prescribing of inhaled steroids for asthma is set to rocket with 600,000 extra patients qualifying for the drugs under new guidelines.

Joint advice from the British Thoracic Society and Scottish Intercollegiate Gui-delines Network recommends that inhaled steroids be prescribed for anyone with mild symptomatic asthma following recent trials showing regular low-dose steroids drastically reduce acute episodes.

GPs have broadly welcom-ed the change but concerns have been raised that mild asthma patients will refuse to take the medication because of fears over side-effects and reluctance to accept they have the condition.

The broadened indication for inhaled steroids now includes patients who have had an exacerbation in the previous two years, are using ß-agonists three or more times a week or are waking at night because of their asthma at least once a week.

Professor David Price, guideline development group member and professor of primary care respiratory medicine at the University of Aberdeen, said there was a 'real need' for GPs to discuss patients' choices frankly with them.

He said: 'You can't force inhaled steroids on people but if they are fully aware of choices they might be more likely to accept them. It does not

have to be all year round,

they might only have to take them during the hay fever

season.'

Dr Dermot Ryan, another member of the guidelines development group and a GP in Loughborough, said studies had indicated that an extra 10 per cent of the UK's 5.5

million asthmatics would now be eligible to take inhaled steroids.

But he warned: 'Some patients will not take inhaled steroids anyway. We need to reassure them but some doctors aren't convinced themselves, which makes it more difficult.'

SIGN/BTS recommendations in brief

lPrescribe inhaled steroids for mild asthma symptoms

lGreater emphasis on asthma 'action plans' for

all patients

lMore GP education and training needed

lRegular patient reviews by GP as per new contract quality framework

lGuidance will be kept up to date at www.sign.ac.uk

By Rob Finch and Cato Pedder

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