GINA guidelines on asthma and beyond^*

Abstract

Clinical guidelines are systematically developed statements designed to help practitioners and patients make decisions regarding the appropriate health care for specific circumstances. Guidelines are based on the scientific evidence on therapeutic interventions. The first asthma guidelines were published in the mid 1980s when asthma became a recognized public health problem in many countries. The Global Initiative on Asthma (GINA) was launched in 1995 as a collaborative effort between the NHLBI and the World Health Organization (WHO). The first edition was opinion‐based but updates were evidence‐based. A new update of the GINA guidelines was recently available and it is based on the control of the disease. Asthma guidelines are prepared to stimulate the implementation of practical guidelines in order to reduce the global burden of asthma. Although asthma guidelines may not be perfect, they appear to be the best vehicle available to assist primary care physicians and patients to receive the best possible care of asthma.

A Method to Calculate Adherence to Inhaled Therapy that Reflects the Changes in Clinical Features of Asthma

“…Inclusion criteria were patients aged ≥18 already prescribed therapy equivalent to step 3 or higher on the Asthma Management Guidelines (23,24) who, in addition, had at least one exacerbation treated with systemic glucocorticoids in the prior year. The dose of inhaled corticosteroid and long acting beta-agonist (LABA) was not changed during the study.…”

“…Change in AQLQ (26,27) was divided into those who did (improvers) and did not (non-improvers) have an improvement of 0.5 points (the minimal clinically important difference in AQLQ). Change in PEF was also categorised into improvers and non-improvers based on a 10% cut off (23,24).…”

Tendência temporal de asma em crianças e adolescentes no Brasil no período de 1998 a 2008

“…18 Asthma affects all ages, especially children and adolescents. 6 Although several studies on asthma prevalence have been performed worldwide, there is no consensus on a single accurate measure to defi ne this disease, a which is usually assessed with a medical diagnosis or the presence of its symptoms. prevalence of asthma in childhood, with a reduction in mortality rates in the same period.…”

Tradução e adaptação cultural do Asthma Control Scoring System (Sistema de Escore para Controle Abrangente da Asma) para uso no Brasil

“…(22) Therefore, monitoring the level of control by assessing different domains is an integral and essential part of the management of asthma patients. (1,23) Some authors have stated that, in a superficial assessment, the parameters used in clinical practice can erroneously classify a patient with poorly controlled asthma as having well controlled asthma, (24) and this can consequently result in insufficient treatment and a higher risk of morbidity. In addition, overestimating severity can lead to an excessive use of drugs, unnecessarily increasing costs (25) and risks, with potential adverse effects of treatment.…”