Re: Conflicting asthma guidelines cause confusion in primary care
As co-chairs of the NICE guideline committee on asthma, we support the general consensus that a guideline with contributions from NICE and BTS/SIGN covering all aspects of management and care is a desirable aim. It is encouraging that NICE stands ready to take the next steps in developing a single, joint approach.
With regards to our recommendations on diagnosis and monitoring, we appreciate that there are challenges carrying out spirometry and FeNO testing in primary care and in children. However, as objective testing is shown to be cost effective through NICE’s primary care pilot study and in robust economic models developed by our committee, we feel that this can be achieved through the right support and resources.
We acknowledge that it will take time before it can be established as routine practice. NICE’s advice is to use current approaches to diagnosis from the BTS/SIGN guidance until capacity is in place.
Competing interests:
Dr Andrew Menzies-Gow and Dr John Alexander were co-chairs of the NICE guideline on asthma: diagnosis, monitoring and chronic asthma management.
Dr Andrew Menzies-Gow has attended advisory boards for GlaxoSmithKline, Novartis, AstraZeneca, Boehringer Ingelheim and Teva. He has received speaker fees from Novartis, AstraZeneca, Vectura, Boehringer Ingelheim and Teva. He has participated in research with Hoffman La Roche, GlaxoSmithKline, Boehringer Ingelheim and Astra Zeneca He has attended international conferences with Astra Zeneca and Boehringer Ingelheim and has consultancy agreements with AstraZeneca and Vectura.
12 January 2018
Andrew N Menzies-Gow
Consultant Respiratory Physician
Dr John Alexander Consultant Paediatrician at Royal Stoke University Hospital
Royal Brompton Hospital
Royal Brompton Hospital, Sydney Street, London, SW3 6NP
Rapid Response:
Re: Conflicting asthma guidelines cause confusion in primary care
As co-chairs of the NICE guideline committee on asthma, we support the general consensus that a guideline with contributions from NICE and BTS/SIGN covering all aspects of management and care is a desirable aim. It is encouraging that NICE stands ready to take the next steps in developing a single, joint approach.
With regards to our recommendations on diagnosis and monitoring, we appreciate that there are challenges carrying out spirometry and FeNO testing in primary care and in children. However, as objective testing is shown to be cost effective through NICE’s primary care pilot study and in robust economic models developed by our committee, we feel that this can be achieved through the right support and resources.
We acknowledge that it will take time before it can be established as routine practice. NICE’s advice is to use current approaches to diagnosis from the BTS/SIGN guidance until capacity is in place.
Competing interests: Dr Andrew Menzies-Gow and Dr John Alexander were co-chairs of the NICE guideline on asthma: diagnosis, monitoring and chronic asthma management. Dr Andrew Menzies-Gow has attended advisory boards for GlaxoSmithKline, Novartis, AstraZeneca, Boehringer Ingelheim and Teva. He has received speaker fees from Novartis, AstraZeneca, Vectura, Boehringer Ingelheim and Teva. He has participated in research with Hoffman La Roche, GlaxoSmithKline, Boehringer Ingelheim and Astra Zeneca He has attended international conferences with Astra Zeneca and Boehringer Ingelheim and has consultancy agreements with AstraZeneca and Vectura.