ACE Clinical Guidances (ACGs)

[also known as Appropriate Care Guides]

ACGs provide concise, evidence-based recommendations to inform specific areas of clinical practice and serve as a common starting point nationally for clinical decision-making. ACGs are underpinned by a wide array of considerations contextualised to Singapore, based on best available evidence at the time of development. Each ACG is developed in collaboration with a multidisciplinary group of local experts representing relevant specialties and practice settings. ACGs are not exhaustive of the subject matter and do not replace clinical judgement.

Published on 15 Oct 2020
Last Updated on 15 Oct 2020
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This ACE Clinical Guidance (ACG) covers clinical assessment, pharmacological treatment, and non-pharmacological strategies for managing asthma over the long term, with a focus on inhaled corticosteroid as the mainstay. The accompanying Appendix provides a list of preventer medications registered for asthma in Singapore.

Download the PDF below to access the ACG.

ACG recommendations
1. Regularly assess asthma symptoms and risk of poor asthma outcomes, including factors that can influence these.
2. Consider using a validated questionnaire to assess asthma symptoms.
3. Assess factors influencing asthma symptoms or risk of poor asthma outcomes. These can be remembered with the acronym BREATHE.
4. Use inhaled corticosteroid as the mainstay of long-term asthma management.
5. For patients aged 6 years and older, do not use short-acting betaagonist alone (without a preventer) to treat asthma long term.
6. Use a stepwise approach when selecting or adjusting preventer treatment for asthma (see Figure 2 on page 6).
7. Educate all patients with asthma or their caregivers on how to self-manage.
8. Regularly follow up all patients with asthma.
9. Referral to a specialist could be made at any point.

 

Asthma and COVID-19

Local experts in Singapore have recently published a summary of international recommendations on asthma management during the COVID-19 pandemic, including use of spirometry, long-term asthma medications, and management of acute exacerbations.* Please note that recommendations in this area may change rapidly, corresponding to the evolution of evidence on COVID-19.

Find the article here.

* Ong KY, Tan TL, Chan AKW, et al. Managing asthma in the COVID-19 pandemic and current recommendations from professional bodies: a review. J Asthma. 2020. Doi: 10.1080/02770903.2020.1804578.

Asthma Management (Nov 2020) Asthma Management Appendix (Oct 2020) Asthma Management References (Oct 2020)