TY - JOUR T1 - In whom should regular asthma controller therapy be initiated? JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - P3829 AU - Alan Kaplan AU - Nadia Grillo AU - Louis-Phillipe Boulet AU - Samir Gupta Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/P3829.abstract N2 - Clinical practice guidelines advise daily asthma management with evidence based recommendations. We analyzed international asthma guidelines (last 5 years): Canadian Thoracic Society (CTS), British Thoracic Society/Scottish Intercollegiate Guidelines Network (BTS/SIGN) & the Global Initiative for Asthma (GINA) guidelines to determine when one should initiate regular controller therapy for a patient with asthma.While all of the guidelines advise starting an uncontrolled patient on controller therapy with inhaled corticosteroids, the thresholds defining a lack of control differ between guidelines.View this table:The threshold for daytime symptom frequency ranges from 2-4 days/week. Lung function criteria differ with an FEV1 or PEF <90% predicted (CTS) & <80% predicted (GINA). The same evidence should lead to similar conclusions, thus differences may arise from methodological differences in evidence collection, critical appraisal, and/or summarization by each committee, and/or a lack of evidence in these areas. Different messages confuse the target audience contributing to guideline distrust among health care practitioners; further limiting the already difficult task of guideline implementation. ER -