Asthma management guide as easy as A²BCD

An easy-to-use, practical guide for managing asthma in a non-specialist setting has been drawn up by international experts to ensure optimal care.

The group, which includes Professor Ian Pavord, Professor of Respiratory Medicine at the University of Oxford and Honorary Consultant Physician at the Oxford University Hospitals, has created a one-page operational guide for disease management suitable for all ages and genders, called A²BCD.

The guide, published in The Lancet Respiratory Medicine, has four components:

– assessing control and risk: asthma control should be assessed with validated questionnaire or questions form GINA, and risk of exacerbations by history, SABA or corticosteroid use, lung impairment and biomarkers;

B – getting right basic measures: such structured patient education, self-management skills including effective inhalation techniques, regular physical activity, and avoidance of triggers use as smoking of NSAIDs;

C – treating comorbidities: assessment and treatment of common co-morbidities such as COPD, sleep apnoea, atopic dermatitis and chronic rhino sinusitis; and

D – treatment with phenotype-specific, individually-targeted treatment with disease-modifying anti-asthmatic drugs (DMAADs), namely inhaled corticosteroid (ICS)-containing inhalations, leukotriene receptor antagonists, biologics, and allergen immunotherapy, to prevent asthma symptoms and exacerbations and ultimately induce and maintain remission.

A²BCD offers a “simplified, concise guide for asthma management according to current, evidence-based treatment concepts”, however, given that there is a lack of research on the uptake and impact of short management guides, its dissemination and implementation “should be done alongside studies in real-world, primary care settings to establish whether the guide is an effective format with the potential to improve outcomes”, the authors stressed.

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