A new ‘roadmap to asthma control’ focuses on how to implement the guidelines of the Global Initiative for Asthma (GINA), aiming to be “less like a textbook and more like a practical manual”.
Associate Professor Helen Reddel, of the Woolcock Institute of Medical Research at the University of Sydney and chair of the GINA Scientific Committee, told the limbic that the changes introduced in the major 2014 revision and a 2015 update of GINA’s global strategy include a new definition of asthma.
“It’s designed to assist in diagnosis of patients with respiratory symptoms in clinical practice and to highlight the heterogeneity of asthma,” she said.
The definition is an ‘umbrella’ term consistent with a need to individualise patients’ management according to the biological features of their disease and behavioural, social and cultural factors.
The new guidelines also use the term ‘flare-up’ instead of ‘exacerbation’, as part of a strategy to improve communication with patients who often did not understand the meaning of an ‘exacerbation’.
Other changes introduced in the GINA report, summarised in a paper in the European Respiratory Journal and highlighted by Professor Reddel, include a framework for tailoring treatment across the whole spectrum of asthma, not just in severe asthma.
“This includes checking for modifiable risk factors and checking inhaler technique and adherence, before considering any treatment step-up,” she says.
“There are also expanded indications for starting preventer treatment in mild asthma and revised recommendations about written asthma action plans.”
The major GINA revision published in 2014 provided the basis for many of the recommendations in the new Australian asthma guidelines (www.asthmahandbook.org.au), also published in 2014, she says.
There are some differences between the two sets of guidelines.