Guidance
This guideline covers diagnosing, monitoring and managing asthma in adults, young people and children. It aims to improve the accuracy of diagnosis, help people to control their asthma and reduce the risk of asthma attacks. It does not cover managing severe asthma or acute asthma attacks.
Last reviewed: 27 November 2024
This is a new collaborative guideline developed jointly by the British Thoracic Society (BTS), National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN).
We reviewed the evidence and made new or updated recommendations on diagnosis, treatment and monitoring. We also updated some recommendations without an evidence review. For full details see update information.
It updates and replaces NICE guideline 80 (published November 2017) and parts of BTS/SIGN British guideline SIGN 158 (published July 2019). It also updates and replaces NICE technology appraisal guidance 10, 38,131 and 138, and NICE diagnostics guidance 12.
Next review: This guidance will be reviewed if there is new evidence that is likely to change the recommendations.
BTS, NICE and SIGN have developed an asthma pathway, which brings together recommendations on diagnosing, monitoring and managing asthma in adults, young people and children. It aims to improve the accuracy of diagnosis, help people to control their asthma and reduce the risk of asthma attacks. It also covers managing difficult and severe asthma and acute asthma attacks.
Recommendations
This guideline includes recommendations on:
- initial assessment
- objective tests for diagnosing asthma and diagnosing asthma in children under 5
- diagnosing occupational asthma
- monitoring asthma control
- pharmacological treatment including, treatment for people aged 12 and over, children aged 5 to 11 and children under 5
- decreasing maintenance therapy
- asthma in pregnancy and breastfeeding
- asthma in adolescents
- adherence and self-management
- risk-stratified care
- organisation and delivery of care
Who is it for?
- Healthcare professionals in primary care and the community, secondary care and tertiary asthma services
- Commissioners and providers
- People with suspected or diagnosed asthma, their families and carers
Guideline development process
How we develop NICE guidelines
This guideline was developed jointly by BTS, NICE and SIGN. The recommendations in this guideline represent the view of BTS, NICE and SIGN, arrived at after careful consideration of the evidence available.
Your responsibility
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.