Summary Report Of New Asthma Guidelines

Main Category: Respiratory / Asthma
Also Included In: Allergy
Article Date: 01 Nov 2007 - 3:00 PDT

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More than 22 million Americans have asthma. It is one of the most common chronic diseases of childhood, affecting about 6 million children. With these statistics in mind, The National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH) recently released the 2007 asthma guidelines, Expert Panel Report 3 (EPR 3): Guidelines for the Diagnosis and Management of Asthma, a report in excess of 300 pages.

A summary of the guidelines will be published as a supplement to the November 2007 issue of the Journal of Allergy and Clinical Immunology (JACI), the official journal of the American Academy of Allergy, Asthma & Immunology (AAAAI). The EPR 3: Guidelines for the Diagnosis and Management of Asthma, Summary Report, 2007, will be available on the JACI's Web site, http://www.jacionline.org on November 8, 2007. This official executive summary highlights in a concise and manageable format the changes made since the report was last updated in 2002.

Great advancements have been made in research and improved scientific understanding of asthma since the guidelines were most recently updated in 2002. The emphasis of the latest guidelines is on control rather than severity. There is an expanded section on childhood asthma, adding an age group of 5 to 11 year olds (this group was previously combined with adults). Included are new recommendations on patient education in settings beyond the physician's office, and updated advice for controlling environmental factors that can cause asthma symptoms. A new section addresses the need for clinician education programs to improve communication with patients, as well as using system-wide approaches to integrate the guidelines into health care practices. This includes the importance of teaching patients to manage their own asthma and to use a written asthma action plan, which should include instruction for daily treatment and ways to recognize and handle worsening asthma. They also encourage expanding these teaching opportunities so the patients can learn in a variety of settings, such as pharmacies, schools, community centers, and even the patients' own homes.

The 2007 recommendations continue to advocate using a stepwise approach to asthma control; therapy is either "stepped up" or "stepped down" in order to maintain control. In the new EPR 3, this stepwise approach grows from four steps to six steps. Medications have also been repositioned within these new six steps and updated to reflect the latest evidence on efficacy.

The guidelines were developed by an expert panel commissioned by the NAEPP Coordinating Committee, coordinated by the NHLBI of the NIH. Using the 1997 EPR 2 guidelines and the 2002 update of the EPR 2 as framework, the expert panel organized the literature review and final guidelines report around four essential components of asthma care, namely: assessment and monitoring, patient education, control of factors contributing to asthma severity, and pharmacologic treatment. Subtopics were developed for each of these four broad categories.

For the full report or more information about the report, go to http://www.nhlbi.nih.gov/guidelines/asthma. For additional information regarding asthma and other allergic diseases, visit http://www.aaaai.org.