BMJ  2007;334:847-850 (21 April), doi:10.1136/bmj.39140.634896.BE

Practice

BMJ Masterclass for GPs

Asthma

¹ Division of Community Health Sciences, GP Section, University of Edinburgh, ² Battersea, London

The first 150 words of the full text of this article appear below.

Introduction

Practical tips Ask specific questions about asthma control, such as the Royal College of Physicians' three questions: people who are used to living with asthma tend not to volunteer their symptoms unless asked specifically Step up treatment if symptoms are not controlled: step down if your patient's asthma is stable People who learn how to control their asthma are less likely to have exacerbations. Every encounter with medical services is an opportunity to review, reinforce, and extend patients' knowledge and skills Patients' action plans should include details of their asthma drugs, advice about when to take further action, what to do if symptoms get worse, when to return to usual doses, and when to seek urgent medical help Rhinitis is a very common comorbidity. Ask patients with asthma about nasal symptoms, and ask patients with rhinitis about wheeze

The prevalence of active asthma in the United Kingdom is 5.8% according to data . . . [Full text of this article]

What should I already know about this condition?

What new evidence do I need to know about?

Telephone reviews
IMPACT trial
How many patients with asthma have rhinitis?
The salmeterol multicentre asthma research trial
Cochrane review

What new guidelines have been produced over the past two years?

The British Thoracic Society (BTS) and Scottish Intercollegiate Guidelines Network (SIGN) guidelines on the management of asthma with web based annual updates
Summary of the British Thoracic Society (BTS) and the Scottish Intercollegiate Guidelines Network (SIGN) guidance on managing asthma⁸
Step 1—Mild intermittent asthma
Step 2—Regular prophylactic therapy
Step 3—Additional therapy
Step 4—Persistent poor control
Step 5—Continuous or frequent use of oral corticosteroids

Practical management tips

When should I refer my patient?

Commonly asked questions—answered by our experts
At what age can we safely diagnose asthma (as opposed to viral induced wheeze) in a toddler?
Should we double inhaled corticosteroids as part of an asthma action plan?
What are the alternatives to long acting agonists as additional therapy?

Common pitfalls

Additional educational resources

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