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
- 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