Department of Respiratory Sciences, University of Leicester, Institute for Lung Health, NIHR Respiratory Biomedical Research Centre, Leicester, UK.
Department of Respiratory Medicine, University Hospitals of Leicester NHS trust, Leicester, UK.
NPJ Prim Care Respir Med. 2024 Jun 27;34(1):16. doi: 10.1038/s41533-024-00379-6.
The British Thoracic Society (BTS) and Scottish Intercollege Guidelines Network (SIGN), as well as National Institute for Health and Care Excellence (NICE), have previously produced separate asthma guidance differing in some key aspects in diagnosis and management leading to confusion, potentially hampering guideline dissemination and uptake. While there are inherent challenges, the upcoming release of new joint BTS/SIGN/NICE asthma guidance presents an opportunity to assess guideline adoption and its impact on clinical practice. The use of prescription data via databases such as OpenPrescribing can be used as a surrogate for guideline adoption and potentially linked to clinical outcomes such as hospital episode statistics (HES). The potential recommendation for anti-inflammatory reliever therapy (AIR) and maintenance and reliever therapy (MART) with inhaled corticosteroid/formoterol combination therapy in the next iteration of UK asthma guidance will require the accurate coding for the respective therapeutic approaches on prescribing platforms in order to assess their impact in real-life clinical practice. This could then direct targeted measures to improve wider guidance adoption leading to better clinical care in asthma based on up to date evidence.
英国胸科学会(BTS)和苏格兰学院间指南网络(SIGN)以及国家卫生与保健卓越研究所(NICE)此前分别制定了哮喘指南,在诊断和管理的某些关键方面存在差异,导致了混淆,可能阻碍了指南的传播和采用。虽然存在内在的挑战,但即将发布的新的 BTS/SIGN/NICE 哮喘指南为评估指南的采用及其对临床实践的影响提供了机会。通过 OpenPrescribing 等数据库使用处方数据可以作为指南采用的替代指标,并可能与医院发病统计数据(HES)等临床结果相关联。在英国哮喘指南的下一个版本中,可能会推荐使用抗炎缓解治疗(AIR)和维持缓解治疗(MART)联合吸入皮质激素/福莫特罗治疗,这将需要在处方平台上准确编码相应的治疗方法,以评估它们在现实临床实践中的影响。这可以指导采取有针对性的措施,提高更广泛的指南采用率,从而根据最新证据改善哮喘的临床护理。