NICE has published guidelines on the management of patients with asthma during the COVID-19 pandemic. Here, Univadis provides a summary of the key recommendations.
Communicating with patients
- Communicate with patients, their families and carers, and support their mental wellbeing, signposting to appropriate services if necessary.
- Advise them to follow UK government advice on shielding and protecting people defined on medical grounds as extremely vulnerable to COVID-19.
General recommendations
- Minimise face-to-face contact.
- If patients need a face-to-face appointment, on the day of the appointment screen them by telephone for COVID‑19 symptoms.
- Ask patients to attend appointments with alone or with no more than 1 other person.
- If a patient has known or suspected COVID‑19, follow appropriate UK government guidance on infection prevention and control, including the use of personal protective equipment (PPE), patient transfers, transport and options for outpatient settings.
Management
- Only carry out bronchoscopy and most pulmonary function tests for urgent cases and if the results will have a direct impact on patient care, because these tests have the potential to spread COVID‑19.
- Patients should continue taking their regular medicines, including those with known or suspected COVID‑19.
Biological treatments
- Patients should continue biological treatment as there is no evidence that biological therapies for asthma suppress immunity.
- Consider self-administered or community-deliver biological treatment.
- Carry out routine monitoring of biological treatment remotely if possible.
- For patients starting on a new biological treatment, balance the risks and benefits of treatment.
- Start treatment even if you are unable to assess adherence in the usual way or a multidisciplinary team discussion is not possible.
- Make sure the patient initiation form on Blueteq is completed and patient data are added to the registry at the earliest opportunity.
Corticosteroids
- Patient should continue using inhaled corticosteroids. There is no evidence that inhaled corticosteroids increase the risk of getting COVID‑19.
- Continue maintenance with oral corticosteroids.
- Patients who develop symptoms and signs of an asthma exacerbation should follow their personalised asthma action plan and start a course of oral corticosteroids if clinically indicated.
Patients should be advised to:
- Wash their hands and clean equipment such as face masks, mouth pieces, spacers and peak flow meters regularly.
- Not share inhalers and devices with others.
- A nebuliser can continue to be used as the aerosol comes from the fluid in the nebuliser chamber and will not carry virus particles from the patient.
References
References
