Adult Asthma Consensus Guidelines update 2003.
BACKGROUND
Several sets of Canadian guidelines for the diagnosis and management of asthma have been published over the past 15 years. Since the last revision of the 1999 Canadian Asthma Consensus Report, important new studies have highlighted the need to incorporate new information into the asthma guidelines.


OBJECTIVE
To review the literature on adult asthma management published between January 2000 and June 2003; to evaluate the influence of the new evidence on the recommendations made in the 1999 Canadian Asthma Consensus Guidelines and its 2001 update; and to report new recommendations on adult asthma management.


METHODS
Three specific topics for which new evidence affected the previous recommendations were selected for review: initial treatment of asthma, add-on therapies in the treatment of asthma and asthma education. The resultant reviews were discussed in June 2003 at a meeting under the auspices of the Canadian Thoracic Society, and recommendations for adult asthma management were reviewed.


RESULTS
The present report emphasises the importance of the early introduction of inhaled corticosteroids in symptomatic patients with mild asthma; stresses the benefit of adding additional therapy, preferably long-acting beta2-agonists, to patients incompletely controlled on low doses of inhaled corticosteroids; and documents the essential role of asthma education.


CONCLUSIONS
The present report generally supports many of the previous recommendations published in the 1999 Canadian Asthma Consensus Report and provides higher levels of evidence for a number of those recommendations.
Lemière
Catherine
C
Université de Montréal, Montreal, Quebec. C-Lemiere@crhsc.umontreal.ca
Bai
Tony
T
Balter
Meyer
M
Bayliff
Charles
C
Becker
Allan
A
Boulet
Louis-Philippe
LP
Bowie
Dennis
D
Cartier
André
A
Cave
Andrew
A
Chapman
Kenneth
K
Cowie
Robert
R
Coyle
Stephen
S
Cockcroft
Donald
D
Ducharme
Francine M
FM
Ernst
Pierre
P
Finlayson
Shelagh
S
FitzGerald
J Mark
JM
Hargreave
Frederick E
FE
Hogg
Donna
D
Kaplan
Alan
A
Kim
Harold
H
Kelm
Cheryle
C
O'Byrne
Paul
P
Sears
Malcolm
M
Markham
Andrea White
AW
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000328:Adult; D001249:Asthma / Q000188:drug therapy*; D002170:Canada; D004502:Education, Medical, Continuing; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use; D010353:Patient Education as Topic
D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D020024:Leukotriene Antagonists