Best practice advice for asthma exacerbation prevention and management in primary care: an international expert consensus
NPJ primary care respiratory medicine · 2024 · DACH
Source and licence
- Authors
- Neil Skolnik, Barbara P. Yawn, Jaime Correia de Sousa et al.
- Title
- Best practice advice for asthma exacerbation prevention and management in primary care: an international expert consensus
- Journal
- NPJ Primary Care Respiratory Medicine, 2024
- Licence
- CC BY 4.0
- Changes
- Verbatim excerpts; formatting adapted
Full text retrieved 2026-10-27 from Europe PMC · PMC11570618
Licence statement of the original publication
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This page reproduces excerpts of the original publication; the original is authoritative. It has not been reviewed by a physician, does not state a recommendation of Medelix and does not replace medical advice. The guideline may have been updated since.
Open the original publication →Full text on Europe PMC
Recommendations
We found no explicitly labelled recommendations in this publication; its recommendations are in the running text of the original.
Abstract
Primary care clinicians play a key role in asthma and asthma exacerbation management worldwide because most patients with asthma are treated in primary care settings. The high burden of asthma exacerbations persists and important practice gaps remain, despite continual advances in asthma care. Lack of primary care-specific guidance, uncontrolled asthma, incomplete assessment of exacerbation and asthma control history, and reliance on systemic corticosteroids or short-acting beta2-agonist-only therapy are challenges clinicians face today with asthma care. Evidence supports the use of inhaled corticosteroids (ICS) + fast-acting bronchodilator treatments when used as needed in response to symptoms to improve asthma control and reduce rates of exacerbations, and the symptoms that occur leading up to an asthma exacerbation provide a window of opportunity to intervene with ICS. Incorporating patient perspectives and preferences when designing asthma regimens will help patients be more engaged in their therapy and may contribute to improved adherence and outcomes. This expert consensus contains 10 Best Practice Advice Points from a panel of primary care clinicians and a patient representative, formed in collaboration with the International Primary Care Respiratory Group (IPCRG), a clinically led charitable organization that works locally and globally in primary care to improve respiratory health. The panel met virtually and developed a series of best practice statements, which were drafted and subsequently voted on to obtain consensus. Primary care clinicians globally are encouraged to review and adapt these best practice advice points on preventing and managing asthma exacerbations to their local practice patterns to enhance asthma care within their practice.
Contents of the original publication
The section headings of the original.
- Introduction
- Methods
- Identify and Assess Asthma Exacerbations
- Best Practice Advice 1: Consider incorporating available validated tools into primary care settings to evaluate asthma status including symptom burden, exacerbation history, and risk
- Best Practice Advice 2: Counsel patients on the warning signs and symptoms of loss of asthma control that may precede exacerbations to facilitate initiation of timely and effective treatment to prevent exacerbations or reduce their severity
- Best Practice Advice 3: Recognize and support education and management plans addressing exacerbation risk for people with all severities of asthma
- Best Practice Advice 4: Evaluate adherence to prescribed therapy (target adherence ≥ 75%) and inhaler technique at all asthma related visits, asking non-judgmental questions, and provide education and support based on that evaluation
- Actively Address Asthma Exacerbation Management and Prevention
- Best Practice Advice 5: Recognize the cumulative adverse effects of systemic corticosteroids (SCS) use and work to avoid their overuse by preventing future exacerbations
- Best Practice Advice 6: Consider the use of AIR, MART (formerly known as SMART) or ICS-SABA quick reliever regimens for treating asthma and exacerbations to address underlying inflammation as well as provide bronchodilation
- Best Practice Advice 7: After an exacerbation, request a patient follow up visit within a short time to explore steps to prevent future exacerbations; these may include providing self-management education, inhaler technique review, adherence evaluation, smoking cessation advice, and an updated asthma action plan, and updating immunizations
- Access to Asthma Care and Treatments
- Best Practice Advice 8: Seek to improve timely access to asthma care and treatments to reduce delays in exacerbation prevention and management
- Best Practice Advice 9: Seek to incorporate patients’ and families’ perspectives, preferences, and goals into asthma care
- Best Practice Advice 10: Encourage and participate in multidisciplinary team-based care of patients with asthma to ensure continuity of care and improved outcomes
- Conclusion
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