Initial management in children aged 5 to 11 | Right Decisions

Right Decisions
Asthma pathway (BTS, NICE, SIGN) [SIGN 244]
Managing chronic asthma
Pharmacological management
Back
Pharmacological management in children aged 5 to 11
Initial management in children aged 5 to 11

Update your RDS mobile app to v4.7.2 to download toolkits even when website is down.

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. You will see that each toolkit has a small QR code icon in the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively update to the latest release - RDS app version 4.7.1 - to see this improvement.

Updating to this latest version of the RDS app is also strongly recommended to get the full benefits of the new resilience arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits. To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

This content is from the BTS, NICE and SIGN guideline - Asthma: diagnosis, monitoring and chronic asthma management (SIGN 245), 2024.

See also algorithm D for a summary of the pharmacological management of asthma in children aged 5 to 11.

R

1.8.1 Offer a twice-daily paediatric low-dose inhaled corticosteroid (ICS), with a short-acting beta₂ agonist (SABA) as needed, as initial treatment for children aged 5 to 11 years with newly diagnosed asthma.

[BTS/NICE/SIGN 2024]

Rationale and impact

Why the committee made the recommendation

Evidence for children aged 5 to 11 showed that regular paediatric low-dose ICS plus SABA as needed was superior to SABA alone, particularly in reducing exacerbations. Using regular ICS did not cause more side effects and was not associated with greater adrenal suppression. There was no evidence for ICS/formoterol combination inhalers used as needed in this age group. The committee therefore recommended regular paediatric low-dose ICS as the preferred treatment option for children aged 5 to 11. However, in view of the evidence supporting the use of ICS/LABA as needed combination inhalers in adults, they made a research recommendation to test the benefits of this combination in children.

How the recommendation might affect practice

The recommendation for treatment of newly diagnosed asthma in children is in line with current practice.

Full details of the evidence and the committee’s discussion are in evidence review P: drug classes for initial asthma management.