GINA has published an executive summary on asthma management and prevention, including rationales for the key recommendations of the strategy.

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The original global asthma strategy was published by the Global Initiative for Asthma (GINA) earlier in 2021, but this new executive summary provides a concise round-up of the key recommendations and offers a clear rationale for each. Among some of the most important areas covered are:

  • diagnosis, including the importance of confirming the diagnosis before treatment initiation
  • personalising the process of assessment, treatment, and review to properly reflect each patient’s unique situation and risk factors as well as their own preferences and goals
  • holistic treatment strategies that address modifiable risk factors and comorbidities and do not solely rely on pharmacological management
  • providing inhaled corticosteroids (ICS) to all adults, adolescents, and children aged 6–11 years with asthma, with frequency tailored to severity
  • the introduction of two treatment ‘tracks’ for the management of adults and adolescents distinguished by inhaled reliever medication across five steps of escalation and de-escalation per track
  • managing wheezing episodes in children of 5 years of age or younger with short-acting beta2 agonists
  • strategies for stepping down pharmacological management to find the minimum effective dose, once asthma has been consistently well-controlled
  • providing a personalised written asthma action plan tailored to each patient
  • when to refer patients for expert advice.

According to the authors of the GINA strategy, the division of treatments for adults and adolescents into a preferred and alternative track (tracks 1 and 2, respectively) is a particularly important change from the 2020 strategy.

Accompanying each recommendation is a detailed rationale that considers the latest evidence, the practicalities of managing asthma, and the factors that affect the decisions made to issue recommendations.

To learn more about implementing the GINA global strategy for asthma, revisit Dr Mark L Levy’s Guidelines in Practice article, GINA asthma strategy: what’s new for 2021? or read the Guidelines summary of the recommendations most relevant to primary care.

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