Japanese Guideline for Childhood Asthma

Abstract

The Japanese Guideline for the Diagnosis and Treatment of Allergic Diseases 2010 (JAGL 2010) describes childhood asthma based on the Japanese Pediatric Guideline for the Treatment and Management of Asthma 2008 (JPGL 2008) published by the Japanese Society of Pediatric Allergy and Clinical Immunology. JAGL 2010 provides information on diagnosis by age groups from infancy to puberty, treatment for acute exacerbations, long-term management by medication, daily life guidance, and patient education to allow physicians, not specialized in childhood asthma, to refer to this guideline for routine medical treatment. JAGL differs from the Global Initiative for Asthma Guideline (GINA) in that the former emphasizes long-term management of childhood asthma based on asthma severity and early diagnosis and intervention at <2 years and 2-5 years of age. However, a management method, including step-up or step-down of long-term management agents based on the status of asthma symptoms, is easy to understand and thus JAGL is suitable for routine medical treatment. JAGL also introduced treatment and management using a control test for children, recommending treatment and management aimed at complete control through avoiding exacerbation factors and appropriate use of antiinflammatory agents.

International consensus on (ICON) pediatric asthma

“…The members of the committee proposed relevant documents to be appraised. These were the Australian Asthma Management Handbook, 2006 (AAMH) , the Global Strategy for Asthma Management and Prevention, published by GINA and updated in 2011 (GINA) , Global Strategy for the Diagnosis and Management of Asthma in Children 5 Years and Younger, 2009 (GINA < 5) , the Japanese Guideline for Childhood Asthma, 2008 (JGCA) , the National Heart and Blood Institute, National Asthma Education and Prevention Program, Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma, 2007 (NAEPP) , the Diagnosis and treatment of Asthma in Childhood: a PRACTALL Consensus Report, 2008 (PRACTALL) , and the British Guideline on the Management of Asthma, Revised 2011 (SIGN) . Each member undertook responsibility for preparing tables and relevant commentaries comparing the included documents in a specific domain.…”

Nutritional status, adiposity and asthma severity and control in children

“…14,21 In this study, we classified asthma severity as intermittent or persistent (mild, moderate and severe), based on NHLBI criteria. Such classification continues to be recommended by current asthma guidelines 23,24 and widely used by recent studies of asthma. [25][26][27][28] In the Australian Asthma Guideline, 29 classification of asthma into intermittent and persistent refers to pattern of asthma rather than severity of disease.…”

Development and validation of asthma questionnaire for assessing and achieving best control in preschool‐age children

“…A standard recall period of 4 weeks was decided for questions on symptoms in order to allow the evaluation of recent asthma control, and 3 different recall periods of 4 weeks, 3 months, and 1 year were decided for questions concerning severe exacerbations to assess the risk domain of asthma. A 5‐point scale for the frequency of symptoms was decided based on the JPGL severity criteria (i.e., ‘none', ‘once in 4 weeks', ‘2–3 times in 4 weeks', ‘every week', and ‘daily'). Another 5‐point scale was employed for the frequency of severe exacerbation episodes in each recall period (i.e., ‘none', ‘once', ‘twice', ‘3 times', and ‘4 times or more'), and 2 Likert scales were also used for the frequency (i.e., ‘none', ‘occasionally', ‘sometimes', ‘often', and ‘always') and the severity (i.e., ‘none', ‘mild', ‘slightly severe', ‘severe', and ‘very severe') of symptoms (Table S1).…”