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Guidelines versus practice: UK asthma nurses often recommend intermittent, symptom-driven use of inhaled
Michael E Hyland1, Sue Blake, Colin J Greaves
1School of Psychology, University of Plymouth, Plymouth, Devon, UK. mhyland@plymouth.ac.uk
Background:
Recent clinical trials suggest that intermittent use of inhaled corticosteroids (ICS) is safe for mild persistent asthma. Intermittent ICS use is inconsistent with current guidelines but is a common form of non-compliance. The aim of this study was to investigate how asthma nurses advise patients to use ICS.
Methods:
Practice managers of 241 GP surgeries in the southwest of England were sent questionnaires to distribute to practice nurses.
Results:
Questionnaires were returned by 105 nurses (104 had asthma-specific training). There was a wide variation in attitudes to guideline-based care and advice given to patients. 97% indicated that they sometimes advised patients to decrease their ICS use, 85% sometimes advised patients to stop their ICS when their asthma was well controlled, and 70% reported sometimes advising intermittent use.
Conclusion:
Asthma nurse recommendations are often inconsistent with guidelines. There is considerable variation between different asthma nurses in the advice given to patients.
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