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.
Abstract
This paper summarises key changes in the GINA global strategy report, a practical new resource for asthma care http://ow.ly/ObvYi
Footnotes
Conflict of interest: Disclosures can be found alongside the online version of this article at erj.ersjournals.com
Support statement: During the period in which the GINA 2014 report was being prepared (2012–2013), the work of GINA was partly supported by unrestricted educational grants from the following companies: Almirall, Boehringer Ingelheim, Boston Scientific, CIPLA, Chiesi, Clement Clarke, GlaxoSmithKline, Merck Sharp and Dohme, Novartis and Takeda. Since 2014, the work of GINA has been supported only by income generated from the sale of its report, resources and related materials. Members of the GINA Committees serve in a voluntary capacity, and are solely responsible for the statements and recommendations in the GINA report and resources. Statements of interest for members of the GINA Science Committee and Board of Directors are published on the GINA website (www.ginasthma.org).
- Received May 29, 2015.
- Accepted June 5, 2015.
- Copyright ©ERS 2015
This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. This article is one of a small annual allocation selected for open access publication at the discretion of the editor.