Asthma Spotlight

An asthma attack is a risk factor for future attacks. This episode of Asthma Spotlight is about preventing future asthma attacks. An asthma exacerbation or attack happens when underlying asthma is poorly controlled and is therefore a clear signal that the management needs to be optimised. So logically, part of the management of an attack should include taking action to identify what went wrong and...

This week, on World Asthma Day GINA ( www.ginasthma.org ) published the 2026 updated evidence based Guidance for management of Asthma. In this podcast, I have shared my initial thoughts on one aspect of this new document, acute asthma management. Four new charts for managing exacerbations/Attacks – two for primary care and two for Emergency departments for children under five and all other ages ha...

Asthma care needs to be improved as a matter of urgency in the United kingdom and probably elsewhere as well. As we near the end of 2025, with evidence of poor outcomes especially in children and young people, its time for a new years resolution for clinicians caring for people with asthma. In my final Asthmaspotlight podcast episode for 2025, I strongly suggest three actions that doctors can take...

New evidence for Anti-inflammatory Reliever Therapy (AIR) in children aged 5-15 with mild asthma. The New Zealand CARE study confirmed that inhaled Budesonide (an anti-inflammatory controller) in combination with formoterol (a fast acting, long-acting bronchodilator ) is more effective than salbutamol reliever in reducing asthma attacks. T the combination Anti-inflammatory reliever inhaler in...

Tragically after 60 years preventable asthma deaths continue in childhood in the UK. The shocking revelation in this interview with Sylvia Stoianova that one child dies every month in England due to asthma is highlighted in the recent report on child deaths due to asthma and anaphylaxis. (NCMD.info/asthma) Despite previous attendances for acute asthma (65%) and anaphylaxis (47%) in the year before...

Canada has amoungst the lowest numbers of asthma deaths in the world. In this interview with Dr Alan Kaplan a Canadian General Practitioner with a special interest in asthma we explore differences in care provided in Canada with that in the United Kingdom. Key differences include that unlike in the UK asthma care in Canada is not delegated to individuals without training in asthma, and that asthma...

Lets end asthma attacks and deaths in 2025! The recent NCMD report ( bit.ly/49Pg1BD ) found that on average one child dies from asthma every month in England. This is one of 25 reports, papers, confidential enquiries published in the UK in the last 60 years. That these potentially preventable deaths continue in the UK is unacceptable. In this podcast Ive made some suggested changes that clinicians...

The National Child mortality database (the NCMD) published a report on deaths in children due to asthma and anaphylaxis in England, between 2019 and 2023. Most of the children who died from asthma had past evidence of well known modifiable risk factors for poor outcomes. Had these factors been identified and acted upon, many of these deaths could possibly have been prevented. This is the 26th publ...

After 5 years, a new UK asthma guideline was published in November 2025. The document is fairly long and has multiple links to other documents which may or may not be read by general practitioners or generalist paediatricians and physicians. So in this podcast I’ve discussed four key messages from the document which in my view could improve asthma care right away. Please do also listen to podcast...

Its 5 years since the UK asthma guidelines were updated. In June 2024 new draft chronic asthma guidelines were published by NICE, the BTS and SIGN. Over 600 feedback responses with comments on this draft were sent to the authors for consideration before publishing the new guideline. In this second of two podcasts I’m joined by Daryl Freeman and Toby Capstick to discuss the treatment section of dra...

It’s 5 years since the UK asthma guidelines were updated. In June 2024 new draft chronic asthma guidelines were published by NICE/BTS/SIGN. Over 600 feedback responses were comments on this draft were sent to the authors for consideration before publishing the new guideline. In this first of two podcasts I’m joined by Daryl Freeman and Toby Capstick to discuss their views on the draft. See https:/...

Many health care professionals who prescribe asthma treatment are not aware of Anti-Inflammatory Reliever (AIR) Therapy. This podcast clarifies this and will hopefully be a ‘light-bulb’ moment for doctors and nurses who prescribe for people with asthma. It will also be helpful for those non-medically trained people delegated to provide assistance and education to understand this treatment for peop...

One of the biggest risks for people with asthma is in those whose asthma is not yet diagnosed. People are often being treated for symptoms, like cough or wheezing without a medical diagnosis. So despite having repeated episodes of respiratory symptoms, these episodes are simply treated as one off acute events with cough mixtures, or antibiotics or inhaler medication. As I’ve said in previous podca...

Asthma attacks and asthma deaths are mostly preventable with good care. There is often a lot of publicity, about people who die from asthma. However, not much about people with asthma who have 'near misses'. i.e. life threatening attacks where the management is below expected. thisa happened recently to a young girl, who I had looked after 5 years ago in a general practice. Mom contacted me andt s...

Severe asthma causes misery for many people, it is underdiagnosed and yet it contributes significantly to poor outcomes due to asthma and is very costly for health care providers. About 3-5% of people with asthma have severe asthma and if suspected or confirmed should be cared for by asthma specialists. In this interview with DR Hitasha Rupani, you will understand a lot about this type of asthma i...

Many colleagues have asked for an explanation on Maintenance and Reliever Therapy (MART) for asthma. Ther is a considerable body of exidence supporting the use of Anti-inflammatory Reliever (AIR) therapy for asthma which is more effective and safer than the use of separate inhalers prescribed for relief and prevention opf asthma. There are two forms of AIR therapy authorised by regulators and thes...

Thefre is no point in doing an asthma review when someone is 100% fit ands well. Asthma is a chronic disease prone to flare ups or attacks which could be life threatening. Its characterised by intermittent symptoms or attacks with other periods when the disease is very well controlled and the person has no symptoms. So performing an assessment may be unhelpful if the person is well on that day. So...

Asthma management in primary care in the UK has reached a stage where patients and doctors are at grave risk. The problem being that a large proportion of asthma care is being delegated inappropriately to individuals (Physician and nurse associates, health care assistants, untrained nurses and pharmacists for eg) who may not be adequately trained for the roles they are being asked to perform. As a...

The tragic death of another child due to asthma is the last straw for me. Most asthma attacks and deaths are potentially preventable. These preventable deaths in children particularly must stop. So Ive developed a 7-step plan to help general practices identify and review all those who have an asthma attack in a regular practice meeting - at least monthly. The key being to identify and fix modifiab...

Continuing the current series on identifying modifiable risk factors that may have contributed to or caused an asthma attack, this podcast is about some of the conditions that may co-exist in addition to asthma. Once identified, they can be dealt with appropriately to try and improve asthma control and prevent future attacks. Please do listen to the episode on a recent inquest that concluded that...

Asthma attacks and deaths are preventable in the vast majority of these episodes. This is the third episode on practical ways that health care professionals can identify and deal with potentially preventable factors that cause asthma attacks - in this case Ive focussed on inhaler technique - the key message being that if someone cannot use their inhaler properly - the drug will not be able to reac...

This is the second episode aimed primarily for general practitioners and emphasises the rationale and need for all those diagnosed with asthma to be prescribed inhaled corticosteroids either as needed depending on the local licence, or regularly. In many asthma attacks and deaths, people have either not been prescribed or are not collecting sufficient inhaled corticosteroid preventer medication. T...

This is the first in a series of discussions to help primary care eradicate asthma attacks and preventable asthma deaths. Following the recent inquest report on a potentially preventable death due to asthma in a 10 year old boy, I am continuing with my attempt to encourage general practices to accept that this is the last straw. Too many potentially preventable asthma deaths continue to be reporte...

An asthma attack is a significant event because it is preventable and can cause harm, even death. So Generakl practitioners should see evry asthma attack in patients as a signal that treatment has failed and make every effiort to identify potentially modifiable risk factors (like excess SABA, insufficient preventer, poor adherence, poor inhaler technique and take action to fix the problem. A simpl...

Asthma attacks and preventable deaths can be reduced by recognising and dealing with modifiable risk factors. Common risk factors for asthma attacks include: excess prescriptions and use of reliever inhalers; insufficient or no prescription of inhaled corticosteroid preventer inhalers; poor inhaler technique; exposure to triggers like non steroidal anti-inflammatory drugs; smoking (including vapin...