New guidelines for asthma treatment

Asthma patients should be warned against e-cigarettes, new guidelines from the National Asthma Council say

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Asthma patients should be warned against e-cigarettes, even if they are using them to stop smoking, new guidelines from the National Asthma Council say.

The group have also updated their asthma and COPD handbook to include clearer advice on how to treat patients with new drugs, which have been the source of some confusion for prescribers.

Professor Amanda Barnard, GP and chair of the National Asthma Council Australia Guidelines Committee, said the update improved information around new medications, “including what conditions they treat, how they differ from existing drugs and clarification of their suitability for long versus short-term use”.

The new handbook also stressed the importance of individualised and regularly reviewed action plans for each and every patient with asthma.

Recommendations around preventer medication in adults were given more clarification in the updated handbook, including a more detail about how to step down medications.

Important changes to the Australian Asthma Handbook

–          Do not recommend e-cigarettes, even as a smoking cessation tool for patients. This consensus advice was included to recognise the increasing use of e-cigarettes but gap in the evidence about their short- and long-term impacts.

–          Every patient with asthma should have a personalised written asthma action plan. This is now the central recommendation, with more detail provided on how to prepare one.

–          Low-dose inhaled corticosteroids are the recommended treatment for most adults with asthma. This clarification explains the rationale for their use and importance in reducing the risk of flare-ups, even when daily symptoms are infrequent.

–          How to improve patient inhaler technique. The majority of patients do not use their inhalers correctly, so information on technique and a table to clarify primer spacing before first use have been included.

–          How to treat patients with add-on therapies such as mepolizumab, omalizumab and tiotropium, as well as new specific allergen immunotherapy preparations.