title: A summary of the new GINA strategy: a roadmap to asthma control.
abstract: Over the past 20 years, the Global Initiative for Asthma (GINA) has regularly published and annually updated a global strategy for asthma management and prevention that has formed the basis for many national guidelines. However, uptake of existing guidelines is poor. A major revision of the GINA report was published in 2014, and updated in 2015, reflecting an evolving understanding of heterogeneous airways disease, a broader evidence base, increasing interest in targeted treatment, and evidence about effective implementation approaches. During development of the report, the clinical utility of recommendations and strategies for their practical implementation were considered in parallel with the scientific evidence.This article provides a summary of key changes in the GINA report, and their rationale. The changes include a revised asthma definition; tools for assessing symptom control and risk factors for adverse outcomes; expanded indications for inhaled corticosteroid therapy; a framework for targeted treatment based on phenotype, modifiable risk factors, patient preference, and practical issues; optimisation of medication effectiveness by addressing inhaler technique and adherence; revised recommendations about written asthma action plans; diagnosis and initial treatment of the asthma-chronic obstructive pulmonary disease overlap syndrome; diagnosis in wheezing pre-school children; and updated strategies for adaptation and implementation of GINA recommendations.
authors.affiliation: Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia helen.reddel@sydney.edu.au.
authors.forename: Helen K
authors.initials: HK
authors.lastname: Reddel
authors.affiliation: University of Cape Town Lung Institute, Cape Town, South Africa.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Bateman
authors.affiliation: University of Manitoba, Winnipeg, MB, Canada.
authors.forename: Allan
authors.initials: A
authors.lastname: Becker
authors.affiliation: Quebec Heart and Lung Institute, Laval University, Québec City, QC, Canada.
authors.forename: Louis-Philippe
authors.initials: LP
authors.lastname: Boulet
authors.affiliation: Federal University of Bahia, Salvador, Brazil.
authors.forename: Alvaro A
authors.initials: AA
authors.lastname: Cruz
authors.affiliation: Harvard Medical School, Boston, MA, USA.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Drazen
authors.affiliation: Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Tari
authors.initials: T
authors.lastname: Haahtela
authors.affiliation: Global Initiative for Asthma, Vancouver, WA, USA.
authors.forename: Suzanne S
authors.initials: SS
authors.lastname: Hurd
authors.affiliation: Kagoshima University, Kagoshima, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Inoue
authors.affiliation: Dept of Pediatrics, Erasmus University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Johan C
authors.initials: JC
authors.lastname: de Jongste
authors.affiliation: University of Wisconsin, Madison, WI, USA.
authors.forename: Robert F
authors.initials: RF
authors.lastname: Lemanske
authors.affiliation: General Practitioner, London, UK.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Levy
authors.affiliation: Firestone Institute of Respiratory Health, St. Joseph's Healthcare and McMaster University, Hamilton, ON, Canada.
authors.forename: Paul M
authors.initials: PM
authors.lastname: O'Byrne
authors.affiliation: University of Pisa, Pisa, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Paggiaro
authors.affiliation: Pediatric Research Unit, University of Southern Denmark, Kolding Hospital, Kolding, Denmark.
authors.forename: Soren E
authors.initials: SE
authors.lastname: Pedersen
authors.affiliation: Universidade Federal de Santa Catarina, NUPAIVA Asthma Research Centre, Florianópolis, Brazil.
authors.forename: Emilio
authors.initials: E
authors.lastname: Pizzichini
authors.affiliation: National Childreńs Hospital, University of Costa Rica San Jose, San Jose, Costa Rica.
authors.forename: Manuel
authors.initials: M
authors.lastname: Soto-Quiroz
authors.affiliation: Children's Hospital Colorado, Aurora, CO, USA.
authors.forename: Stanley J
authors.initials: SJ
authors.lastname: Szefler
authors.affiliation: Dept of Paediatrics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong.
authors.forename: Gary W K
authors.initials: GW
authors.lastname: Wong
authors.affiliation: Institute for Heart and Lung Health, University of British Columbia, Vancouver, BC, Canada.
authors.forename: J Mark
authors.initials: JM
authors.lastname: FitzGerald
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D019468:Disease Management; D005260:Female; D005544:Forecasting; D014943:Global Health; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D012720:Severity of Illness Index
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents