Primary Care Management Prior to referral

  • Simple asthma should be managed in primary care via the BTS guideline steps below – referral is appropriate after ‘additional controller therapies’ step. 
  • Montelukast should be trialled and benefit evaluated, stop if no benefit to patient.
  • Always check inhaler technique & adherence/ script pick up prior to increasing treatment
  • All patients should have a written Personal Asthma Action Plan



When to Refer for Consultant review

  • Poor control despite asthma treatment optimisation.
  • Suspected occupational asthma
  • Unclear diagnosis


Referral Requirements

  • Include in the referral letter the number of ICS containing & salbutamol prescriptions issued and the number of courses of oral steroids over the last 12 months and therapies previously tried
  • Spirometry with reversibility (within the past 6 months)
  • Chest Xray and FBC (within the past 6 months)
  • Provide a peak flow meter & diary, initiate peak flow monitoring where patient is capable