Information to control asthma , prevent asthma attacks and deaths: Updated June 8th 2023
Dr Mark L Levy FRCGP: @bigcatdoc ; @ginasthma
People with asthma can ensure they keep safe by learning as much about asthma as possible. In this way you can learn what questions to ask your doctor and what you could expect for your or your child’s asthma care. Health care professionals of course need access to the most up to date information to keep their patient’s asthma well controlled in order to prevent attacks.
This page contains information and links to resources and publications on asthma. There is a podcast that explains the rationale and use of this information and you can listen to the podcast as well as my other podcasts on asthma at: https://bigcatdoc.com/podcast-asthma-spotlight-2/ and on spotify and Apple Podcasts
Examples of innovative implementation to improve asthma care:
- Post asthma attack review system: A group in Northern Ireland reduced attacks by implementing a system for post attack reviews listen to the podcast interview with authors of this research on 2 August 2023
- New Zealand Asthma Guidelines: A system for implementing Anti-inflammatory Reliever Therapy, and listen to the podcast interview with Professor Richard Beasley on 26th July 2023
National and International Societies for people with asthma:
- National Asthma Council Australia
- Asthma Australia
- Brazilian group Associação Brasileira de Asma Grave
- Asthma and Lung UK (Used to be called the National Asthma Campaign):
- Asthma and Lung UK Scotland
- Asthma and Lung UK – Northern Ireland
- Asthma and Lung UK – Wales
- Allergy UK:
- Anaphylaxis UK:
- Asthma Society of Ireland
- Asthma Canada
- Portugal (GRESP) (CAPA)
- Allergy Foundation South Africa
- Spain (GRAP)
International Patient associations:
- The European Federation of Allergy and Airways Diseases Patients’ Associations (EFA)
- Global Allergies and Asthma Patient Platform
Self management plans to help control asthma to prevent attacks and hospital admission.
- Inhaler technique videos
- Lung and Asthma UK Self Management Plans UK
- For additional action plans with ICS-formoterol reliever, see National Asthma Council Australia Action plan library
- Weekly Asthma Spotlight Podcast episodes – primarily aimed at people with asthma – the podcast provides information on asthma, how it is managed, and how to keep safe by looking after your asthma: https://t.co/mYvVZ4qGf7, Asthmaspotlight, https://apple.co/3Eo2OjR
- Other Podcasts: https://podcasts.apple.com/gb/podcast/why-havent-we-improved-on-asthma-deaths-in-the-uk/id1587318777?i=1000541554716
Monitoring and checking your asthma control:
- The Asthma Control Test (ACT) – for adults and children in many languages-if your score is 19 or less your asthma is uncontrolled
- The SmartRespiratory Peak Flow and inhaler counter apps
- Digital Health Passport – Listen to my interview with Dr Greg Burch on this resource
Specialist Medical Societies: These societies all work to improve the health of people with asthma (and other diseases)- many of their events and educational videos and materials are accessible online . Some of these also have patient working groups and patient representatives.
International professional respiratory / asthma organisations:
- European Respiratory Society
- International Primary Care Respiratory Group (IPCRG):Global AsthmaRightCare page
- Pan African Thoracic Society
- Forum of International Respiratory Societies (FIRS) that includes leading international respiratory societies
- The International Union against Tuberculosis and Lung Disease:
Patient resources from GINA and specialist societies available in Individual countries: These ones listed are those that I’m aware of that have patient representatives or resources for people with asthma
- American Thoracic Society: https://www.thoracic.org/patients/
- Thoracic Society of Australia and New Zealand: https://thoracic.org.au/resources/patient-resources/
- Australia: https://www.asthmahandbook.org.au/resources/patients
- Global Initiative for Asthma: https://ginasthma.org/patients-advocacy-groups/
Guidance and Guidelines to control asthma to prevent attacks and hospitalisation
- The Global Initiative for Asthma (GINA) 2023: – https://ginasthma.org/wp-content/uploads/2023/05/GINA-2023-Full-Report-2023-WMS.pdf – This is an international, annually updated evidence based document which provides guidance for health care practitioners. This is a useful resource for people with asthma if you want to find out what to expect from your own doctor in terms of up to date quality care.
- The Global Initiative for Asthma (GINA) Pocket Guide ( 2023) : https://ginasthma.org/wp-content/uploads/2022/07/GINA-2022-Pocket-Guide-WMS.pdf
- Global Initiative for Asthma Website – for lots of resources including podcasts, tools, and links to publications: www.ginasthma.org
Some examples of Country specific Asthma Guidelines on diagnosis, control, treatment and asthma self-management:
- Australia (2022): https://www.asthmahandbook.org.au
- Canada (2021): https://cts-sct.ca/wp-content/uploads/2022/01/Corrected-Ver_2021_CTS_CPG-DiagnosisManagement_Asthma.pdf
- United Kingdom – British Thoracic Society (2019): https://www.brit-thoracic.org.uk/quality-improvement/guidelines/asthma/
- United Kingdom – NICE (2021 ): https://www.nice.org.uk/guidance/ng80/resources/asthma-diagnosis-monitoring-and-chronic-asthma-management-pdf-1837687975621
- England :National bundle of care for children and young people with asthma, click here
- United States of America (2020 ): https://www.nhlbi.nih.gov/health-topics/asthma-management-guidelines-2020-updates
- United States of America Expert Panel Report Updates (2022 ): https://www.nhlbi.nih.gov/about/advisory-and-peer-review-committees/national-asthma-education-and-prevention-program-coordinating/EPR4-working-group
- South Africa – Adults (2021): https://pulmonology.co.za/wp-content/uploads/2022/04/Guidelines-for-the-management-of-asthma-in-adults.pdf
- New Zealand: This guideline provides a simplified practical approach to the use of Anti-Inflammatory Reliever Treatment (AIR) https://www.nzrespiratoryguidelines.co.nz/
Further Reading and some lectures / webinars:
- National Review of Asthma Deaths (NRAD) – this was a review of asthma deaths during the year from February 2012 in the United Kingdom. A panel of 176 doctors, nurses and pharmacists with expertise in asthma were tasked with assessing the medical records to determine if i) These people had evidence of asthma; ii) If these people died from asthma and iii) if there were any lessons that could be learned from these sad cases: https://www.rcplondon.ac.uk/projects/outputs/why-asthma-still-kills
- This is a link to a half hour webinar I did on the post attack review – if you have had an asthma attack, it means that something serious went wrong and therefore by listening to this talk that was intended for health care professionals, you can find out what to expect, and to ask for when you attend your doctor for a check-up or review after you had an attack
- Chapter on acute asthma: SIGN/BTS 158 (2019) https://www.brit-thoracic.org.uk/quality-improvement/guidelines/asthma/ (Ch 9) – this was last updated in 2019, and the chapter on acute asthma is helpful for assessment by health professionals and also for people with asthma (and parents of children with asthma)
- Article summarising GINA 2022 recommendations – intended for General Practitioners and General physicians and Paediatricians – and may be useful for people with asthma to understand how some treatment decisions are based on evidence and used by doctors: https://www.nature.com/articles/s41533-023-00330-1
- JACI Paper on MART- this is an article explaining Maintenance and Reliever Treatment for asthma which also includes a link to a MART self management plan : https://www.jaci-inpractice.org/article/S2213-2198(21)01128-4/fulltext
Training Resources on Asthma for doctors and nurses:
UK Resources:
Press
Correct use of inhaler images can help to educate people with asthma and health care professionals. The blue reliever inhalers are NOT intended for regular use – they are for emergency use and for temporary relief of symptoms. For royalty free images available from IPCRG click here
Occupational Asthma – some resources:
- List of substances that can cause occupational asthma
- Guidance for employers and workers
- Guidelines
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