Asthma is diagnosed by the presence of one or more symptoms and the presence of variable airflow obstruction. NICE recommends objective tests, which include spirometry and fractional exhaled nitric oxide (FeNO), to help confirm a diagnosis of asthma in addition to peak expiratory flow (PEF). FeNO tests measure the levels of nitric oxide in the breath where increased levels are thought to be related to lung inflammation and asthma.

Mainstay treatments aim to reduce inflammation and increase bronchodilation. Inhalation is the preferred route of administration due to the reduced side-effect profile (compared to systemic absorption). Bronchodilators also have a much faster onset of action when administered via inhalation but poor compliance with inhalers is a common issue.

There are approximately 400 asthma patients per pharmacy so the pharmacy team is well placed to assist with patient care and medicines optimisation. The major adherence issue relating to patients taking asthma medicines appears to be a lack of understanding of how to use the medicine most effectively.

Let’s now look at the medicines available.