Just out of interest-BTS Guidelines

I am currently on the British Thoracic society guidelines stage 4 and was on the understanding that stage 5 was were you were requiring regular oral steroids however, I was reading the other day that this doesn't necessarily need to steroids taken daily it can be were a person requires regular courses of oral steroids. As I am on my 6th course this year I am guessing thats regular courses.

So out of interest does this make me a BTS stage 5? The thing is I don't feel my asthma is bad enough to be BTS 5

10 Replies

  • I just went and read them myself! As I understand it, you (and I) would count as Stage 5. I guess there must be a lot of variation in the severity of people in this group.

    Did Stage 5 use to be permanently on oral steroids (it says they were revised in 2009)?


  • hi

    are either of you under a respiratory consultant? I think when you think you are having lots of steriods is the time you should be asking to be referred to a consultant. In the BTS guidelines i am not in them because i am under a consultant and have steriods daily all the time. I do find the guidelines confusing once you start taking steriods regularly.


  • Plumie- I am under a respiratory consultant. I agree the guidelines do seem a bit confusing when you get to stage 5, there seems to be less information on stage 5! (or maybe I think that because it is the one I am interested in).


  • Yes I am under a fantastic consultant who really up to date on difficult asthma.

  • Reply to 'Just out of interest-BTS Guidelines'

    im on stage four yet i have never had steriods i thought my asthma wasn't severe the guidelines are confusing but they do help after a while

  • The most interesting thing about your opening post, Wanda, was your last line:

    ""The thing is I don't feel my asthma is bad enough to be BTS 5""

    I think that this is the point of a really well-executed treatment regime. Remember, the guidelines demonstrate how severe your asthma is *without* treatment, and the level of treatment you require to maintain control of your asthma. The fact that you don't feel your asthma is as bad as the BTS guidelines suggest it is means that your treatment regime is working.

    I too get very confused by the BTS guidelines once you go past step 4. I know a number of people who are now on treatment regimes that go well beyond anything stage 5 suggests, and I think that stage 4 is the last stage that's really clearly defined in a way that I can understand it!

  • Well i guess i must be BTS stage 5 as i am on steriods all the time and under a consultant. I am very high levels of medication and still barely have any control.


  • My GP seems to have me at level 4.... but hasn't tried all the level 3 options. I guess there maybe a good reason but have changed GPs today.

    Good so far, was introduced to a doctor while filling in the registration forms, then got my new patient check with the nurse straight after. I've gone on a recommendation so am confident things will improve for me :)

    Many thanks to Asthma UK for their time this morning. Knowing that I was sane gave me the confidence to make the decision and do the move

  • The problem with these sort of quidelines is that so many people look at things differently and it is all purely subjective. I myself am type 1 brittle and as such am on stage 5 with home nebuliser therapy.

    Maybe this is one you could talk to your doc about?

  • Must confess I don't pay attention to what stage I am at. Just aim to get some control wie wot ever I get prescribed or try !!!

    Sometime when labelled at stages we become fixed at treatment only for that stage where asthma treatments are usually tweaked and individual to a person

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