Asthma management guidelines: updates, advances, and new options.
BACKGROUND
Asthma still poses a substantial and unacceptable health and economic burden. The National Asthma Education and Prevention Program (NAEPP) guidelines for the management of asthma continue to evolve based on emerging clinical data, improving the understanding of asthma and approaches to its management.


OBJECTIVE
To examine the clinical implications of current NAEPP guidelines for the diagnosis and treatment of asthma and the potential impact of the proposed 2007 guidelines update on asthma management. To examine the role of managed care organizations in fostering evidence-based asthma management.


CONCLUSIONS
Current NAEPP guidelines recognize symptom control as the chief therapeutic target in the management of asthma. The proposed update to NAEPP guidelines places greater emphasis on symptom control by expanding its definition to not only include measures of impairment but also the risk for deteriorating pulmonary function, asthma exacerbations, and controller medication side effects. Although inhaled corticosteroids remain central to achieving long-term asthma control in both current and proposed guidelines, the latter offers greater treatment flexibility and recognizes combination therapy as a preferred choice for achieving control in many patients with moderate persistent asthma. Managed care organizations, primarily using disease management programs, provide impetus for the widespread adoption of evidence-based asthma treatment guidelines.


CONCLUSIONS
Widespread adoption of evidence-based asthma management programs offers the opportunity for achieving and maintaining asthma control.
Navarro
Robert P
RP
NavarroPharma, LLC, Raleigh, North Carolina 27613, USA. p.navarro@gmail.com
Schaecher
Kenneth L
KL
Rice
Gary K
GK
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D019468:Disease Management; D019317:Evidence-Based Medicine; D006801:Humans; D008329:Managed Care Programs; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D011322:Primary Prevention / Q000379:methods / Q000592:standards; D014481:United States
D000305:Adrenal Cortex Hormones