Asthma: diagnosis, monitoring and chronic asthma management

Diagnosing asthma in children and young people aged 5 to 16:- What is the acceptability and diagnostic accuracy of objective tests that could be used to comprise
a diagnostic pathway for asthma in children and young people aged 5 to 16 (for example, exercise challenge, direct bronchial challenge with histamine or methacholine, indirect bronchial challenge with mannitol and peripheral blood eosinophil count)?

Improving adherence to asthma medication:- What are the most clinically and cost-effective strategies to improve medicines adherence in adults, young people and children with asthma who are non-adherent to prescribed medicines?

Increasing the dose of ICS within a personalised self-management programme for children and young people - For children and young people with asthma that is managed in primary care, is there an advantage to increasing the inhaled corticosteroid (ICS) dose when asthma control has deteriorated compared with using the usual dose in a self-management programme?

Diagnosing asthma in adults (aged 17 and over):- What is the clinical and cost effectiveness of using an indirect bronchial challenge test with mannitol to diagnose asthma in adults (aged 17 and over)?

Monitoring adherence to treatment:- What is the clinical and cost effectiveness of using electronic alert systems designed to monitor and improve adherence with regular inhaled maintenance therapy in people with asthma?

Monitoring inhaler technique:- What is the current frequency and the current method being used to check the inhaler technique of people with asthma? What is the optimal frequency and the best method of checking inhaler technique to improve clinical outcomes for people with asthma?

Monitoring asthma control using tele-healthcare:- What is the long-term (more than 12 months) clinical and cost effectiveness of using telehealthcare as a means to monitor asthma control in adults, young people and children? Methods of tele-healthcare can include telephone interview (with healthcare professional involvement) and
internet or smartphone-based monitoring support (no healthcare professional involvement).

Starting asthma treatment:- In adults, young people and children with asthma who have not been treated previously, is it more clinically and cost effective to start treatment with a reliever alone (a short-acting beta2 agonist [SABA]) or with a reliever (a SABA) and maintenance therapy (such as ICS)? Are there specific
prognostic features that indicate that one of these treatment options may be more appropriate for some groups?

Second-line maintenance therapy in children and young people (under 16):- Is maintenance therapy more effective with a paediatric low dose of ICS plus a leukotriene receptor antagonist (LTRA) or with a paediatric low dose of ICS plus a long-acting beta2 agonist (LABA) in the treatment of asthma in children and young people (under 16) who have uncontrolled asthma on a paediatric low dose of ICS alone?

Additional maintenance therapy for asthma uncontrolled on a moderate dose of ICS plus LABA with or without LTRA:- What is the clinical and cost effectiveness of offering additional maintenance therapy to adults, young people and children with asthma that is uncontrolled on a moderate dose of ICS plus LABA with or without LTRA?

Decreasing pharmacological treatment:- In adults, young people and children with well-controlled asthma, what are the objective measurements and prognostic factors that indicate that a decrease in regular maintenance treatment is appropriate?