The New England Journal of Medicine

The PARTICS group (intervention) used 1 puff of beclomethasone 80mcg (QVAR) with each puff of rescue beta-agonist and 5 puffs of QVAR when they used nebulized beta-agonist.

Asthma exacerbations were significantly reduced, asthma control improved, and patients decreased their use of beta-agonists.  The average yearly increase of controller medications (accounting for a reduction in maintenance controllers) was only 1.1 cannisters a year

Prescription Information

Prescription will be for a medium dose inhaled steroid (see table below) with the instructions
Use 1 puff of [ICS] for every 1 puff of rescue inhaler [e.g., albuterol] and 5 puffs with rescue nebulizer”.

Prescription should be written in addition to, NOT IN PLACE OF, any of your patient’s regular asthma medications
Most insurances should cover this, but in some cases you may need to appeal a denial.

Note: The use of ICS as part of rescue therapy is now backed by US asthma guidelines (NAEPP EPR4) as well as the GINA international asthma guidelines.

Medium Dose ICS Table

Educational Materials/Videos