The British Thoracic Society (BTS) unveiled the latest advancement in asthma care with the release of the "Asthma 4" - Asthma Attack bundle, tailored specifically for adult patients (aged 16+) following acute asthma episodes. Building upon the foundation laid by the inaugural Asthma Care Bundle in 2016, this updated resource introduces a comprehensive set of clinical interventions aimed at enhancing patient outcomes post-asthma attack. Informed by recent innovations in asthma clinical practice, such as biologic therapies, the Asthma 4 bundle addresses the evolving landscape of asthma management. 

Designed for implementation across various clinical settings, including primary, urgent, and emergency care, the Asthma 4 bundle focuses solely on adult patients, unlike its predecessor which included considerations for paediatric cases. Key objectives of this initiative encompass reducing the risk of recurrent asthma attacks, minimising hospital readmissions, and facilitating appropriate follow-up and referrals if necessary. 

Central to the Asthma 4 bundle is the introduction of the "Asthma 4" framework, comprising four impactful and measurable actions to guide healthcare professionals in optimising asthma care: 

• Medication review: ensuring patients receive appropriate inhaled corticosteroid-containing inhalers, with emphasis on proper inhaler technique and adherence assessment. 

• Personalised asthma action plan: providing patients with individualised self-management plans, co-designed to accommodate their unique needs and circumstances. 

• Tobacco dependence support: offering brief advice and specialist referral for current smokers, with a focus on eventual cessation for vape users. 

• Clinical review within four weeks: scheduling a follow-up appointment with a healthcare professional trained in asthma care to confirm diagnosis, assess treatment efficacy, and plan further interventions. 

Dr Hitasha Rupani, Consultant Respiratory Physician and Chair of the BTS Asthma Advisory Group, underscores the significance of the Asthma 4 bundle in enhancing clinical care and improving asthma outcomes. By emphasising essential components of patient review and promoting follow-up, the Asthma 4 initiative aims to elevate the standard of asthma management and optimise patient well-being. 

The full bundle can be accessed here: BTS Asthma care bundles | British Thoracic Society | Better lung health for all (brit-thoracic.org.uk)