WELCOME TO SENTINEL PLUS
This medical education website has been funded by AstraZeneca and co-developed with Hull University Teaching Hospitals NHS Trust. This website is intended for UK healthcare professionals only.
GOLD STANDARD 1
SABA inhalers should not be prescribed using a repeat prescription without a robust system in place to ensure SABA...
GOLD STANDARD 2
Inhaler technique should be taught and reviewed during every asthma consultation, to ensure that all asthma patients are...
GOLD STANDARD 3
Adherence with inhaled therapy should be addressed each time an asthma patient is...
GOLD STANDARD 4
All patients using as-needed AIR or MART should have SABA discontinued* within 3 months and be advised to return...
GOLD STANDARD 5
All patients prescribed a SABA inhaler that have a confirmed diagnosis of asthma should also be prescribed...
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GOLD STANDARD 1
SABA inhalers should not be prescribed using a repeat prescription without a robust system in place to ensure SABA over-reliance is identified and addressed.
GOLD STANDARD 2
Inhaler technique should be taught and reviewed during every asthma consultation, to ensure that all asthma patients are prescribed and issued an inhaler that they are able to use...
GOLD STANDARD 3
Adherence with inhaled therapy should be addressed each time an asthma patient is reviewed.
GOLD STANDARD 4
All patients using as-needed AIR or MART should have SABA discontinued* within 3 months and be advised to return unused SABA to their pharmacy.
GOLD STANDARD 5
All patients prescribed a SABA inhaler that have a confirmed diagnosis of asthma should also be prescribed a preventer inhaler.
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References
- Bloom, CI et al. Adv Ther. 2020; 37(10): 4190-4208
- British Thoracic Society. British guideline on the management of asthma. July 2021. Available from https://www.brit-thoracic.org.uk/clinical-resources/guidelines/asthma-chronic/ (Accessed May 2026)
- Wilkinson, AJK et al. BTS Oral Abstract No: S26. Available from http://dx.doi.org/10.1136/thorax-2020-BTSabstracts.32 (Accessed May 2026)
- Wilkinson A. et al. Greenhouse gas emissions associated with asthma care in the UK: results from SABINA CARBON. Abstract presented at European Respiratory Society (ERS) International Congress, 2021; Sep 5-8: Abstract no. OA76
- Jonkers RE et al, Respir Res 2006; 7: 141
- Singh, D et al. Pulmonary Pharmacology & Therapeutics 2012; 25: 392-398
GB-76218 | May 2026
GOLD
STANDARD 1
SABA inhalers should not be prescribed using a repeat prescription without a robust system in place to ensure SABA over-reliance is identified and addressed.
SABA over-reliance (using 3 or more SABA canisters per year) is associated with increased risk of asthma exacerbations.1 Early identification of SABA over-reliance provides an opportunity to optimise asthma care in order to achieve asthma control with the aim of reducing the risk of future asthma exacerbations.
GOLD
STANDARD 2
Inhaler technique should be taught and reviewed during every asthma consultation, to ensure that all asthma patients are prescribed and issued an inhaler that they are able to use.
GOLD
STANDARD 3
Adherence with inhaled therapy should be addressed each time an asthma patient is reviewed.
Non-adherence with inhaled corticosteroids is a recognised reason for poor asthma control. For patients using SABA relievers, frequent SABA use can suggest poor asthma control and therefore review of preventer medication adherence will allow non-adherence to be identified and addressed. For patients using anti-inflammatory based management, it is important to ensure that they are using their inhaled therapies as intended.2
GOLD
STANDARD 4
All patients using as-needed AIR or MART should have SABA discontinued* within 3 months and be advised to return unused SABA to their pharmacy.
SABA over-reliance is associated with negative outcomes for asthma patients and contributes to the carbon footprint of asthma treatment in the UK.3,4 Using a DPI (dry powder inhaler) can help reduce asthma exacerbations and additionally contribute to the reduction of greenhouse gas emissions. Co-prescription of AIR or MART and a SABA inhaler risks confusing patients and undermines these approaches.
*SABA can be discontinued for most patients at the time an anti-inflammatory reliever inhaler is prescribed because formoterol containing ICS/LABA inhalers are as effective at relieving bronchospasm and symptoms as SABA. For patients that are psychologically dependent on their SABA, a phased withdrawal over 3 months may be appropriate.
GOLD
STANDARD 5
All patients prescribed a SABA inhaler that have a confirmed diagnosis of asthma should also be prescribed a preventer inhaler.
In patients aged 12 and over who are newly diagnosed with asthma or who are on SABA monotherapy are recommended an ICS/formoterol combination inhaler, as as needed AIR (Anti-inflammatory Reliever).Those who are uncontrolled on existing asthma treatments, are presenting as highly symptomatic or where there are severe exacerbations are considered for initiation on a ICS/Formoterol MART (Maintenance and Reliever Therapy) where required. This recognizes the inflammatory nature of asthma and the importance of anti-inflammatory treatments. SABA-only treatment in asthma is associated with increased risk of exacerbations and is not recommended.2:
Uncontrolled asthma can include one or more of:
- Use of a reliever inhaler on 3 or more days per week
- Asthma causing night-time waking on 1 or more nights per week
- Any asthma attack requiring treatment with oral corticosteroids
SENTINEL Plus is developed with the aim of improving outcomes for asthma patients through identifying and addressing short-acting beta 2 agonist (SABA) over-reliance
GB-76210 | May 2026