A GP guide to managing mild asthma

The new 'as-needed-only' treatment option for adults and adolescents provides GPs with an important opportunity to discuss and review patients' asthma management

Need to know:

  • Asthma treatment for adults and adolescents is graded level 1–5, according to the intensity of medication (type, number and dose) needed to control symptoms and prevent exacerbations. Level 1 is as-needed short-acting beta2 agonist (SABA) only, and level 5 is specialised add-on treatments.
  • As-needed low-dose budesonide–formoterol is a new level 2 treatment option for managing mild asthma in adults and adolescents.
  • Most patients need level 2 treatment —  either regular daily maintenance low-dose inhaled corticosteroid (ICS) plus as-needed SABA or as-needed low-dose budesonide–formoterol.
  • Treatment on demand, in response to symptoms, may be particularly suitable for patients with poor adherence to daily maintenance ICS treatment.
  • For patients whose asthma is not well controlled by a level 2 treatment option, treatment should be stepped up to level 3 — maintenance treatment with the combination of low