3 Treatment

Patients having biological treatment

3.1 Tell patients, or their parent or carer, that they should continue treatment because there is no evidence that biological therapies for asthma suppress immunity.

3.2 If the patient usually attends hospital to have biological treatments, think about if they can be trained to self-administer, or could be treated at a community clinic or at home.

3.3 Carry out routine monitoring of biological treatment remotely if possible.

Patients starting biological treatment

3.4 When patients start on a new biological treatment, balance the risks and benefits of treatment, and take into account service modifications.

3.5 Start treatment even if:

  • you're not able to assess adherence to regular treatment in the usual way

  • a multidisciplinary team discussion is not possible; 2 senior clinicians in the commissioned service, or delegated by the commissioned service, may make the decision to start biological treatment.

3.6 Make sure that:

  • the patient initiation form on Blueteq is completed; for continuation and annual review forms, make sure forms are completed at a future date

  • patient data are added to the registry at the earliest opportunity, after getting patient consent; this can be deferred but, if it is, make arrangements to complete it at a future date.

3.7 Have arrangements in place to enable patient self-administration or homecare for subsequent doses, to reduce the need for patients to come into hospital for treatment. Some homecare medicine delivery services are not accepting new referrals, in which case the department would need to organise this.

Corticosteroids

3.8 Tell patients, or their parent or carer, to continue using inhaled corticosteroids because stopping can increase the risk of asthma exacerbation. Tell them there is no evidence that inhaled corticosteroids increase the risk of getting COVID‑19.

3.9 Tell patients on maintenance oral corticosteroids, or their parent or carer, to continue to take them at their prescribed dose because stopping them can be harmful.

3.10 Tell patients, or their parent or carer, that if they develop symptoms and signs of an asthma exacerbation, they should follow their personalised asthma action plan and start a course of oral corticosteroids if clinically indicated.