Global strategy for asthma management and prevention: GINA executive summary

Abstract

Asthma is a serious health problem throughout the world. During the past two decades, many scientific advances have improved our understanding of asthma and ability to manage and control it effectively. However, recommendations for asthma care need to be adapted to local conditions, resources and services. Since it was formed in 1993, the Global Initiative for Asthma, a network of individuals, organisations and public health officials, has played a leading role in disseminating information about the care of patients with asthma based on a process of continuous review of published scientific investigations. A comprehensive workshop report entitled ''A Global Strategy for Asthma Management and Prevention'', first published in 1995, has been widely adopted, translated and reproduced, and forms the basis for many national guidelines. The 2006 report contains important new themes. First, it asserts that ''it is reasonable to expect that in most patients with asthma, control of the disease can and should be achieved and maintained,'' and recommends a change in approach to asthma management, with asthma control, rather than asthma severity, being the focus of treatment decisions. The importance of the patient-care giver partnership and guided self-management, along with setting goals for treatment, are also emphasised.

Real-life study showing uncontrolled rhinosinusitis after sinus surgery in a tertiary referral centre

“…Although state‐of‐the‐art guidelines provide evidence‐based treatment algorithms, a significant portion of patients remain uncontrolled, despite prolonged medical treatment and one or more surgical interventions. The recently proposed criteria for defining control of CRS by the EPOS expert committee were designed following the concept of the asthma control test of the GINA (Global Initiative for Asthma) guidelines 11. However, these criteria should still be validated.…”

Pre-operative pulmonary assessment for patients with hip fracture

“…Ideally, patients should be symptoms-free with a peak expiratory flow greater than 80% of the predicted or personal best value before surgery [56]. A short course of systemic corticosteroid (e.g., oral prednisone 0.5–1 mg/kg or equivalent), starting from 1 to 2 days before surgery, should be given to patients at risk for PPCs [57].…”

Variation in allergen content in sublingual allergen immunotherapy with house dust mites

“…Currently, 20 meta‐analyses assessing effectiveness of AIT in various indications (asthma and rhinitis), by different administration routes and based on different allergens are available, but only a few products available for prescription are represented in existing meta‐analyses 7. Then, an allergist is not sure whether the products available to prescribe are effective 8, 9.…”