A personal perspective on using the plan on a page tool to support the development of FeNO services. An article on using the FeNO Plan-on-a-Page tool, with accompanying working example and editable template.
The PCRS Integrated Care Board (ICB), Health Board and Trust toolkit aims to support healthcare commissioners across the UK to implement the new BTS/NICE/SIGN asthma guideline effectively and ensure the best possible care and outcome for all their asthma patients.
2024 marked a pivotal change in the management of asthma in the UK with the publication of a joint British Thoracic Society (BTS), National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN) guideline. This guideline, ‘Asthma: diagnosis, monitoring and chronic asthma management’, has the potential to be the paradigm shift that is needed to improve asthma care in the UK.
Over the past 20-years, there has been an increased focus on the use of newer biologic medication in people with severe asthma that is not controlled with usual asthma medication. Although there are currently six biologics (January 2025) licensed for use in severe asthma, estimates suggest that of the 60,000 people potentially eligible for biologics in England, only 8,000-10,000 are on these treatments.
Now is the time to make MART moves for asthma. We have been using the separate blue (reliever) and brown (preventer) inhalers for far too long. The National Review of Asthma Deaths (NRAD) came out a decade ago, yet as a nation, we still have the highest asthma death rate in Europe. This is unsurprising, considering many patients still rely on their blue inhalers alone. However,
Maintenance and reliever therapy (MART) is a treatment for asthma where a single combined inhaler is used for both maintenance and reliever purposes, instead of having separate preventer (brown) and reliever (blue) inhalers.
Inhalation is the main route for administration of drugs for conditions such as asthma or chronic obstructive pulmonary disease. The advantage of administering drugs by inhaler is that drugs are delivered directly to the site of action within the airways. The onset of action is rapid and systemic adverse effects are minimised. However, for an inhaler to be effective the correct drug must be prescribed and the device must be used correctly. Poor inhaler technique is common.
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