What is new since the last (1999) Canadian Asthma Consensus Guidelines?
The objective of the present document is to review the impact of new information on the recommendations made in the last (1999) Canadian Asthma Consensus Guidelines. It includes relevant published studies and observations or comments regarding what are considered to be the main issues in asthma management in children and adults in office, emergency department, hospital and clinical settings. Asthma is still insufficiently controlled in a large number of patients, and practice guidelines need to be integrated better with current care. This report re-emphasises the need for the following: objective measures of airflow obstruction to confirm the diagnosis of asthma suggested by the clinical evaluation; identification of contributing factors; and the establishment of a treatment plan to rapidly obtain and maintain optimal asthma control according to specific criteria. Recent publications support the essential role of asthma education and environmental control in asthma management. They further support the role of inhaled corticosteroids as the mainstay of anti-inflammatory therapy of asthma, and of both long acting beta2-agonists and leukotriene antagonists as effective means to improve asthma control when inhaled corticosteroids are insufficient. New developments, such as combination therapy, and recent major trials, such as the Children's Asthma Management Project (CAMP) study, are discussed.
Boulet
L P
LP
Hôpital Laval, Sainte-Foy, Canada. lpboulet@med.ulaval.ca
Bai
T R
TR
Becker
A
A
Bérubé
D
D
Beveridge
R
R
Bowie
D M
DM
Chapman
K R
KR
Côté
J
J
Cockcroft
D
D
Ducharme
F M
FM
Ernst
P
P
FitzGerald
J M
JM
Kovesi
T
T
Hodder
R V
RV
O'Byrne
P
P
Rowe
B
B
Sears
M R
MR
Simons
F E
FE
Spier
S
S
D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D000328:Adult; D000485:Allergens; D000818:Animals; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001249:Asthma / Q000276:immunology / Q000517:prevention & control / Q000628:therapy*; D002170:Canada; D004632:Emergency Medical Services; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use*; D008925:Mites / Q000276:immunology; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D013256:Steroids
D000318:Adrenergic beta-Agonists; D000485:Allergens; D018927:Anti-Asthmatic Agents; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D020024:Leukotriene Antagonists; D013256:Steroids