Difficult to treat / severe asthma

This section is intended for clinicians caring for children with asthma in primary, community, hospital or tertiary care setting. It outlines examples of best practice in the assessment, treatment and ongoing management of children and young people with asthma in an acute setting.

There are a number of children who have persistent symptoms or frequent exacerbations (or both) despite optimal management in secondary care. Children with problematic severe asthma should be referred to a specialist difficult asthma team in tertiary care.

The referral pathway, designed by the Severe Asthma Network subgroup of the London Asthma Leadership and Innovation Group, shows the route to a specialist (tertiary) severe asthma service for children aged 5 – 16 years with problematic asthma. Referrals can be made from primary or secondary care.

The National Bundle of Care for CYP with asthma has a section on severe asthma including an outline of what a severe asthma service should provide.


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