Asthma Reviews: What Happens and What the Latest UK Guidance Means for You

In short: Everyone with asthma should have a review at least once a year, and after any asthma attack. A review checks your symptoms, how often you use your reliever, your inhaler technique and your personal asthma action plan. UK guidance from the British Thoracic Society, NICE and SIGN, published together in 2024 (NICE NG245), changed how asthma is diagnosed and treated, with more use of objective tests and combination inhalers that contain an inhaled steroid.

This guide, written by a Ready Health prescribing pharmacist and based on the joint BTS/NICE/SIGN guideline, explains what happens at an asthma review and what the current UK approach to treatment looks like.

Why are asthma reviews important?

Asthma can change over time, and many asthma attacks happen in people whose symptoms were not well controlled beforehand. A review is a chance to spot warning signs early, such as using your reliever inhaler often, waking at night with symptoms or needing courses of steroid tablets.

What happens during an asthma review?

• Symptom check: often using a short questionnaire about day and night symptoms and activity
• Attacks and steroid tablets: any asthma attacks, A&E visits or oral steroid courses since the last review
• Reliever use: how often you use it and how many reliever inhalers you have needed
• Inhaler technique: watching you use your inhaler, as poor technique is very common
• Adherence: whether you can take preventer treatment as prescribed, and any barriers
• Triggers and lifestyle: smoking, vaping, allergies, work exposures and other conditions such as rhinitis
• Lung function: peak flow, and sometimes spirometry or FeNO testing
• Personal asthma action plan: a written plan explaining what to do when symptoms worsen

How is asthma diagnosed under the 2024 guideline?

The guideline recommends confirming asthma with objective tests rather than symptoms alone. For adults, these are usually:

• FeNO (fractional exhaled nitric oxide) and/or a blood eosinophil count, which look for airway inflammation
• spirometry with a bronchodilator reversibility test
• peak flow monitoring over two weeks if needed
• a bronchial challenge test in a specialist setting if the diagnosis is still unclear

Children aged 5 to 16 follow a similar approach, with FeNO and spirometry usually first.

How is asthma treated in the UK now?

A key principle of the current guideline is that people with asthma should not be treated with a short-acting reliever inhaler alone, because this is linked to a higher risk of asthma attacks. Treatment should include an inhaled corticosteroid (steroid).

If you were diagnosed some years ago, your treatment may differ from this. Do not change or stop your inhalers on your own: a clinician will review whether a change suits you and explain how to use any new inhaler.

What are the warning signs of poorly controlled asthma?

• needing your reliever three or more times a week
• waking at night because of asthma
• symptoms limiting exercise or daily activities
• needing a course of steroid tablets

Get emergency help (call 999) if your reliever is not helping, you are too breathless to speak, eat or sleep, your lips or fingers look blue or grey, or you feel drowsy or confused.

Frequently asked questions

How often should I have an asthma review?

At least once a year, and soon after any asthma attack or change in treatment. Your GP practice usually invites you.

What is a FeNO test?

You breathe steadily into a small device, which measures nitric oxide in your breath. Higher levels suggest a type of airway inflammation common in asthma.

Can I have a private asthma review?

Yes. A private review can offer a convenient appointment, but it is important that results and any changes are shared with your NHS GP, who usually manages your ongoing prescriptions.

Do I need to bring my inhalers?

Yes. Bring all your inhalers, any spacer and your action plan so your technique and treatment can be checked.

Key takeaways

• Have an asthma review at least once a year and after every attack.
• Asthma should be confirmed with objective tests such as FeNO and spirometry.
• Treatment should include an inhaled steroid, not a reliever on its own.
• Check your inhaler technique and keep your personal asthma action plan up to date.
• Only change inhalers after discussion with a clinician.

Sources and further reading

• NICE NG245: Asthma – diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN)
• NHS: Asthma
• Asthma + Lung UK: Asthma

Last reviewed: October 2026 by Shamir Patel, Independent Prescribing Pharmacist, Ready Health. This article is general information and does not replace advice from your own clinician.

If you would like your asthma, inhaler technique or action plan reviewed, you can book a private GP appointment at Ready Health in Standish, Wigan. We will share the outcome with your NHS GP with your consent.