British guidelines on the management of asthma: what's new for 2011?
- 1Department of Child Health, Royal Aberdeen Children's Hospital, Aberdeen, UK
- 2Department of Paediatric Respiratory Medicine and School of Medicine, University of Glasgow, Royal Hospital for Sick Children, Glasgow, UK
- 3Respiratory Unit, Freeman Hospital, Newcastle upon Tyne, Tyne and Wear, UK
- 4Respiratory Unit, Aberdeen Royal Infirmary, Aberdeen, UK
- Correspondence to Dr Graham Douglas, Respiratory Unit, Aberdeen Royal Infirmary, Aberdeen AB25 2ZN, UK;
Contributors All four contributors are members of the Steering Committee of the British Guidelines on the Management of Asthma. BH and GD are co-chairs of the whole guideline while ST and JP are chairs of the Evidence Review Groups for each of these two new sections.
- Received 18 March 2011
- Accepted 8 June 2011
- Published Online First 27 June 2011
Since 1999 the British Guidelines on the Management of Asthma have been produced jointly by the British Thoracic Society (BTS) and Scottish Intercollegiate Guideline Network (SIGN) using a rigorous evidence-based methodology. Sections within the guideline have been revised regularly, with the Pharmacological Management section being updated nearly every year. We believe this has resulted in a ‘living guideline’ that is responsive to new research and is current for clinicians. For 2011, two new sections have been added on Monitoring and Control and Asthma in Adolescents.
Monitoring and control
There is increasing awareness that current control is a good predictor of future exacerbations.1 There is also some evidence that biomarkers might be useful in predicting future asthma control.2 Perhaps not unexpectedly, this new section is able to identify more areas where evidence is lacking than where evidence can be found to support practice. In adults and children there is very little evidence that addition of biomarkers to validated symptom scores improves asthma control; indeed, most of the evidence points towards biomarkers not assisting in the management of asthma. Such biomarkers include peak expiratory flow, spirometry, bronchial hyper-responsiveness and exhaled nitric oxide (Feno). Although not …