Asthma (older children) - inhaler devices

Summary

A press-and-breathe pressurised metered dose inhaler used with an appropriate spacer is recommended as the first choice of inhaler for use with inhaled corticosteroid medicines for asthma (preventers). If a clinician believes that it is so unlikely that an individual child will use the press-and-breathe inhaler and spacer properly that his or her asthma control may be affected, other inhalers should be considered.

For other inhaled medicines for asthma, such as bronchodilators (relievers), a wider range of inhalers should be considered. This recommendation takes into account that the child is more likely to have to carry this inhaler around with him or her so that it is available for use when needed.

The choice of inhaler should be determined by individual needs, including the medicine the child needs, and the child’s ability and willingness to use a particular inhaler. If, after these factors have been taken into account, there is more than one inhaler to choose from, the inhaler with the lowest overall cost to the NHS should be chosen.

The health professionals who help to look after a child with asthma will support the proper use of the inhaler. From time to time, they will check that the inhaler being used remains the best one for the child.

Documents

For healthcare professionals

• TA38 Asthma (older children) - inhaler devices: Summary (pdf)
• TA38 Asthma (older children) - inhaler devices: Guidance (pdf)

For patients, carers and the public

• TA38 Asthma (older children) - inhaler devices: Information for the public

Background information

• Review decision
• Review proposal
• 2002/020 NICE issues guidance on inhalers for older children with chronic asthma
• Appeal panel decision: Asthma (older children) - inhaler devices (No. 38)
• HTA report: Asthma (older children) - inhaler devices

Implementing this guidance

Any further information NICE has produced to help the NHS implement this guideline locally is linked to below:

• None found