National Asthma Guidelines Updated


Vol. 16 •Issue 8 • Page 8
First Thoughts

National Asthma Guidelines Updated

The National Asthma Education and Prevention Program released the first major overhaul of asthma treatment guidelines in more than a decade.

They couldn’t have come at a better time. Not only does the largest number of hospitalizations related to asthma occur in the fall, but also two reports have revealed stumbling blocks to asthma control in children.

The guidelines are the end result of a panel of experts’ review of the latest scientific medical literature related to asthma management. They emphasize asthma can be controlled in most cases, but it’s an ever-changing condition. Consequently, it takes a partnership between physician, patients, and parents to monitor symptoms regularly and adjust treatment.

“The goal of asthma therapy is to control asthma so that patients can live active, full lives while minimizing their risk of asthma exacerbations and other problems,” said William W. Busse, MD, chairman of the expert panel, in a statement issued by the National Institutes of Health.

The guidelines focus on four components: measures to assess and monitor asthma; patient education; control of environmental factors and other conditions that can worsen asthma; and medications.

For example, the guidelines include new recommendations on patient education in settings beyond the physician’s office. This is much needed information, considering a recent survey of parents of school-age children with asthma conducted by the American Lung Association.

It found 59 percent of parents were unsure if their state had laws or regulations that require schools to allow students to carry and use asthma inhalers. Connecticut, Louisiana, South Dakota, and Vermont are the only states without such requirements; however, 75 percent of parents said their schools don’t allow students to keep rescue medications with them.

In addition, 40 percent of parents had never heard of a written asthma action plan, which is a key component of asthma management advocated in the new NAEPP guidelines. Physicians, families, and educators should heed this advice and insist that written asthma action plans are in place in schools to ensure students’ access to lifesaving medications.

The NAEPP update also reaffirms that inhaled corticosteroids are the most effective long-term control medication across all age groups. Unfortunately, another survey revealed parents’ misconceptions about the drugs may lead to noncompliance.

Researchers from the University of Rochester Medical Center in New York found only 14 percent of parents followed their child’s medication regimen as completely as directed. One is six parents feared the harm the drugs might do. The new guidelines reiterate that regular use of inhaled steroids is generally safe.

Both surveys demonstrate the need for better communication between physicians, patients, and their parents. More than 22 million people in the U.S. have asthma, including 6.5 million children under age 18, according to the Centers for Disease Control and Prevention.

That’s a ton of people who need to hear about these new guidelines. It’s up to you to bridge this gap and turn the evidence into clinical practice to more effectively provide quality asthma care.

The Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma, 2007, can be viewed at www.nhlbi.nih.gov/guidelines/asthma/index.htm.

Sharlene George, Editor, sgeorge@merion.com

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