There are two sets of national asthma guidelines currently in effect:

·      NICE guideline NG80 ‘Asthma: diagnosis, monitoring and chronic asthma management’, published in November 2017, with a small but significant amendment in 2020 relating to children’s self-care plans7

·      The British Thoracic Society (BTS) and Scottish Intercollegiate Guidelines Network (SIGN) guideline ‘SIGN 158 – British guideline on the management of asthma’, revised in July 2019.8

The Primary Care Respiratory Society (PCRS) consensus document ‘Asthma Guidelines in Practice’ looks at the differences between the NICE and BTS/SIGN guidelines, and was updated in 2019. It emphasises that regular ICS therapy should be the foundation of asthma pharmacological treatment.9

PCRS also initiated the Asthma Right Care (ARC) campaign to take a stand “against the overreliance on reliever inhalers experienced by many people with asthma, and the overprescribing that perpetuates this”.10

One of the reasons for the differences between the two sets of guidelines is that NICE additionally takes economic evaluations into account. The terminology for child ICS doses also differs. The BTS/SIGN guidelines use ‘very low dose’, ‘low dose’, and ‘medium dose’ for what NICE describes as ‘paediatric low dose’, ‘paediatric medium dose’ and ‘paediatric high dose’ respectively.9

However, NICE, the BTS and SIGN have agreed they will work together to produce future UK-wide guidance on chronic asthma.11