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The asthma guidelines in the UK were revised in January 2012 and are based upon research developed by asthma experts at the Scottish Intercollegiate Guidelines Network and the British Thoracic Society. If you have asthma you will be aware that this is a long-term condition, needing careful management in partnership with your doctor or asthma nurse and in practicing environmental allergen control.
The UK asthma guidlines cover:
- Drug treatment for asthma
- Non-drug treatment, including alternative medicine approaches
- Self-management and patient education
- How care should be organised and delivered
- Asthma during pregnancy
- Occupational asthma
- Management of asthma attacks
There is some interesting information on non-pharmacological management that may inspire some 'self-help' tips for people with asthma.
This is what the guidelines have to say on asthma prevention (primary prevention):
- Breastfeeding is to be encouraged, because it may have a potential protective effect against childhood asthma.
- There is limited evidence that fish oil, selenium and vitamin E in pregnancy may prevent asthma in the baby, but this is insufficient to allow any specific recommendations on supplementation.
- There is a proven link between maternal smoking and risk of infant wheezing. Therefore, parents (and parents-to-be) should be advised not to smoke.
On secondary prevention (managing existing asthma to avoid attacks), here's what the guidelines have to say:
- Air pollution has been shown to aggravate asthma and a lot of research has been done in this area, particularly into the impact of indoor air pollution. Depending on where pollution is coming from, the most effective way to control indoor air pollution is the use of an effective air purifier.
- Measures to reduce house dust mite do have an effect and the guidelines do believe that a multi-pronged approach to mite reduction is worthwhile.
- Exposure to cigarette smoke adversely affects lung function and long-term control of asthma. So people with asthma who smoke should be encouraged to stop.
Allergen-specific allergy shots can be helpful in the management of allergic asthma. The guidelines therefore say that immunotherapy can be considered in people with asthma where it is hard to avoid an allergen. But the potential for severe allergic reactions to the therapy must be considered and discussed with the patient.
It is also worth keeping an eye on developments at the National Institute for Health and Clinical Excellence (NICE), whose mission is to make sure healthcare professionals in the NHS provide the best quality of care while keeping an eye on value for money. In February 2013, NICE is to issue a Quality Standard on asthma. You can view the draft of this at: www.nice.org.uk/media/541/9D/Draft_Asthma_QS.pdf