ArticleSouth African family practice : official journal of the South African Academy of Family Practice/Primary Care2020
The Global Initiative for Asthma 2019 recommendation for mild asthma - A critique.
Article in South African family practice : official journal of the South African Academy of Family Practice/Primary Care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- The Changing Asthma Management Landscape and Need for Appropriate SABA Prescription.Advances in therapy · 2023Article
- Severe asthma in South Africa: A literature review and management approach for primary care.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2021Review
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Authors and funding
1 author.
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Abstract
Recognising 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.
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