The global initiative for asthma 2019 recommendation for mild asthma – a critique

dc.contributor.authorIrusen, Elvis M.en_ZA
dc.date.accessioned2020-07-13T11:57:47Z
dc.date.available2020-07-13T11:57:47Z
dc.date.issued2020-03-05
dc.descriptionCITATION: Irusen, E. M. 2020. The global initiative for asthma 2019 recommendation for mild asthma – a critique. South African Family Practice, 62(1):a5104, doi:10.4102/safp.v62i1.5104.
dc.descriptionThe original publication is available at http://www.safpj.co.za
dc.descriptionPublication of this article was funded by the Stellenbosch University Open Access Fund.
dc.description.abstractRecognising that mild asthmatics are at risk of exacerbations and mortality, the Global Initiative for Asthma (GINA) issued an updated strategy in 2019. This was premised on two studies culminating in their recommendation that mild asthma should be treated by using a combination of a rapid and long-acting beta 2 agonist and an inhaled corticosteroid (ICS) administered as required. Their rationale is, however, debatable, as the studies actually showed that regular daily ICS administration was more effective for a number of asthma control endpoints. A patient-driven treatment strategy is also questionable, as there are a number of concerns about behaviour of patients suffering from asthma and perception of airway narrowing that should trigger medication intake but in fact does not do so. These deficiencies also influence a similar maintenance and reliever treatment (MART) approach that would be suboptimal. Intermittent ICS regimens are also inferior when compared to regular treatment. Not all asthmatics respond to the same dose of ICS. The best way to manage asthma is by adopting a step-up ICS approach, to encompass varying disease severity, with a long-acting beta agonist taken on a daily basis, ideally in a single combination inhaler.en_ZA
dc.description.urihttps://safpj.co.za/index.php/safpj/article/view/5104
dc.description.versionPublisher's version
dc.format.extent4 pagesen_ZA
dc.identifier.citationIrusen, E. M. 2020. The global initiative for asthma 2019 recommendation for mild asthma – a critique. South African Family Practice, 62(1):a5104, doi:10.4102/safp.v62i1.5104
dc.identifier.issn078-6204 (online)
dc.identifier.issn2078-6190 (print)
dc.identifier.otherdoi:10.4102/safp.v62i1.5104
dc.identifier.urihttp://hdl.handle.net/10019.1/108701
dc.language.isoen_ZAen_ZA
dc.publisherAOSIS
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectMild asthmaen_ZA
dc.subjectAsthmatics -- Careen_ZA
dc.subjectAdrenocorticoids -- Inhalersen_ZA
dc.titleThe global initiative for asthma 2019 recommendation for mild asthma – a critiqueen_ZA
dc.typeArticleen_ZA
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