Asthma Management

Asthma – optimising long-term management with inhaled corticosteroid

Asthma is a chronic respiratory condition commonly seen in primary care. The management goal for asthma is to prevent or minimise symptoms and reduce risk of poor outcomes.

A significant shift in the approach to treating asthma has come about recently, which can help patients to be more symptom-free, and less likely to experience exacerbations, among other benefits.

ACE Clinical Update Service (CUES) is bringing this key update, along with other relevant developments and practice points on long-term asthma management to private general practitioners (GPs). With CME accreditation, ACE CUES is Singapore’s first nationwide educational visiting service for healthcare professionals. Educational visiting is a form of continuing professional education in which updates based on best available evidence are delivered through personalised discussions. Topic-specific materials or tools to aid in patient education, in keeping with the ACE Clinical Guidance (ACG) on asthma, will also be provided as part of ACE CUES to support clinical practice.

Keeping to COVID-19 precautions, ACE CUES is offering online discussions in place of face-to-face visits for now.

Click here to sign up for ACE CUES or find out more.

GPs who participate in ACE CUES on the asthma management topic will receive:

• Up to 2 educational visiting sessions in 6 months
• Useful tools for patient education
• CME points
• And more!

Asthma resources for healthcare professionals and patients

1. Written asthma action plan (WAAP)

A WAAP is a patient-specific set of instructions for managing asthma completed by the doctor or another suitably trained healthcare professional together with the patient (or caregiver).

Different WAAP templates exist. However, they should all include space for clear and individualised information on:

• The patient's usual asthma medications (preventer, reliever), including medication name, route, dose, and frequency
• Adjusting asthma medications when symptoms are worsening
• Recognising an asthma-related emergency and how to seek help

A WAAP should be kept in multiple places that are convenient and accessible (for example, at home, at the workplace, in the bag, or saved as a digital copy on mobile phone). As the patient’s asthma condition or medications may change over time, regular review of the WAAP between the healthcare professional and the patient (or caregiver) is important.

Click on the links below for selected WAAP templates (for healthcare professionals to choose, according to applicability to their patients and practice).

2. Inhaler technique videos

It is important to use your inhaler with correct technique, so that the medication gets to your lungs to treat the asthma. Click on the links below to watch short videos on correct inhaler technique.

Click on the relevant inhaler image to get started
Accuhaler	Easyhaler	Ellipta
Forspiro	NEXThaler	pMDI
pMDI with spacer	pMDI with spacer and face mask	Turbuhaler

pMDI, pressurised metered dose inhaler

Accuhaler Click here for video (Source: Asthma UK*) Accuhalers registered in Singapore for asthma Seretide Accuhaler, Ventolin Accuhaler

Easyhaler Click here for video (Source: Asthma UK*) Easyhalers registered in Singapore for asthma Beclomet Easyhaler, Buventol Easyhaler, Giona Easyhaler

Ellipta Click here for video (Source: Asthma UK*) Elliptas registered in Singapore for asthma Arnuity Ellipta, Relvar Ellipta

Forspiro Click here for video (Source: Asthma UK*) Note: As you use the inhaler, the foil strip will become longer. Please tear it off when there are more than 3 sections (called “blisters” in the video) on the foil strip, otherwise the inhaler may get jammed. Forspiro registered in Singapore for asthma AirFluSal Forspiro

NEXThaler Click here for video (Source: Asthma UK*) NEXThaler registered in Singapore for asthma Foster NEXThaler

pMDI Click here for video (Source: Asthma UK*) pMDIs registered in Singapore for asthma Alvesco inhaler, Azmasol inhaler, Beclo-asma inhaler, Budiair inhaler, Clenil inhaler, Flixotide Evohaler, Flutiform inhaler, Foster inhaler, Salbuair inhaler, Salbutamol Sandoz inhaler, Seretide Evohaler, Symbicort Rapihaler, Ventolin Evohaler, Zenhale inhaler

pMDI with spacer There are 2 breathing techniques for using a pMDI with a spacer – tidal breathing, or single breath and hold. Please use the breathing technique advised by your healthcare professional: For adult – tidal breathing, click here for video For adult – single breath and hold, click here for video For child – tidal breathing, or single breath and hold, click here for video (Source: Asthma UK*) Note: For tidal breathing technique, the number of breaths needed may differ between adults and children, and between spacer brands. pMDIs registered in Singapore for asthma Alvesco inhaler, Azmasol inhaler, Beclo-asma inhaler, Budiair inhaler, Clenil inhaler, Flixotide Evohaler, Flutiform inhaler, Foster inhaler, Salbuair inhaler, Salbutamol Sandoz inhaler, Seretide Evohaler, Symbicort Rapihaler, Ventolin Evohaler, Zenhale inhaler

pMDI with spacer and face mask There are 2 breathing techniques for using a pMDI with a spacer and face mask – tidal breathing, or single breath and hold. Please use the technique advised by your healthcare professional: For adult, click here for video For child, click here for video (Source: Asthma UK*) Note: For tidal breathing technique, the number of breaths needed may differ between adults and children, and between spacer brands. pMDIs registered in Singapore for asthma Alvesco inhaler, Azmasol inhaler, Beclo-asma inhaler, Budiair inhaler, Clenil inhaler, Flixotide Evohaler, Flutiform inhaler, Foster inhaler, Salbuair inhaler, Salbutamol Sandoz inhaler, Seretide Evohaler, Symbicort Rapihaler, Ventolin Evohaler, Zenhale inhaler

Turbuhaler (also known as Turbohaler) Click here for video (Source: Asthma UK*) Turbuhalers registered in Singapore for asthma Pulmicort Turbuhaler, Symbicort Turbuhaler

* The charity Asthma UK is part of the Asthma UK and British Lung Foundation Partnership.

Statement of intent:
The information provided on this webpage and the linked webpages is to assist healthcare professionals and patients (persons with asthma) in managing/treating asthma. The information is not exhaustive of the subject matter and does not replace clinical judgement of or advice from a healthcare professional. The responsibility for exercising clinical judgement and making decisions appropriate to the circumstances of the individual patient remains at all times with the healthcare professional. Patients (or their caregivers) are advised to speak to their healthcare professionals for further information about their asthma treatment.

Disclaimer:
The Ministry of Health, Singapore disclaims any and all liability to any party for any direct, indirect, implied, punitive or other consequential damages arising directly or indirectly from any use of this webpage and the linked webpages, which are provided as is, without warranties.