Disease Management & Health Outcomes

, Volume 1, Issue 6, pp 296–303 | Cite as

Guidelines for Asthma

Relating Local Needs to Global Initiatives
  • Richard A. Nicklas
  • Albert L. Sheffer
Review Article Guidelines


International guidelines for the management of asthma are now available. These include the US National Heart, Lung, and Blood Institute (NHLBI) International Consensus for the Diagnosis and Treatment of Asthma and the NHLBI/World Health Organization Global Initiative for Asthma (GINA).

The main purpose of such guidelines is to improve the quality of care for patients with asthma. This can only be accomplished, however, if these documents are effectively utilised. Effective utilisation will require the preparation of guidelines that can be readily adapted to requirements of local healthcare providers. To do this, consideration must be given to socioeconomic and practice differences within and between countries.


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  1. 1.
    Field MJ, Lohr KN, editors. Institute of Medicine. Clinical practice guidelines: directions for a new program. Washington, DC: National Academy Press, 1990Google Scholar
  2. 2.
    Bernstein IL, Storms WW, editors. Practice parameters for allergy diagnostic testing. Ann Allergy 1995; 75(6): 553–4Google Scholar
  3. 3.
    Nicklas RA, Spector SL, Bernstein IL, et al. Practice parameters [editorial]. J Allergy Clin Immunol 1995; 96: 1–4PubMedCrossRefGoogle Scholar
  4. 4.
    National Institutes of Health, National Heart, Lung and Blood Institute. NIH/NHLBI Global Strategy for Asthma Management and Prevention NHLBI/WHO workshop report. Global initiative for asthma. Bethesda (MD): National Institutes of Health, National Heart, Lung and Blood Institute; 1995 Jan. Report no. 95-3659Google Scholar
  5. 5.
    Spector SL, Nicklas RA, editors. Practice parameters for the diagnosis and treatment of asthma. J Allergy Clin Immunol 1995; 96 (5 Pt 2): 707–9Google Scholar
  6. 6.
    Kostreski F. Agency goes commercial: AHCPR will no longer develop guidelines. Intern Med News 1996 Jun 15: 5Google Scholar
  7. 7.
    American Thoracic Society. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma. Am Rev Respir Dis 1987; 136: 225–44CrossRefGoogle Scholar
  8. 8.
    Woolcock A, Rubinfield AR, Seale JP, et al. Asthma management plan 1989. Med J Aust 1989; 151: 650–3PubMedGoogle Scholar
  9. 9.
    Hargreave FE, Dolovich J, Newhouse JT. The assessment and treatment of asthma: a conference report. J Allergy Clin Immunol 1990; 85: 1098–111PubMedCrossRefGoogle Scholar
  10. 10.
    The British Thoracic Society, National Asthma Campaign, Royal College of Physicians of London, et al. The British guidelines on asthma management: 1995 review and position statement. Thorax 1997; 52 Suppl. 1: S1–S21Google Scholar
  11. 11.
    Eccles M, Clapp Z, Grimshaw J, et al. North of England evidence based guidelines development project: summary version of evidence based guideline for the primary care management of asthma in adults. BMJ 1996; 312: 762–6CrossRefGoogle Scholar
  12. 12.
    Warner JO, Gotz M, Landau LI, et al. Management of asthma: a consensus statement. Arch Dis Child 1989; 64: 1065–79PubMedCrossRefGoogle Scholar
  13. 13.
    NAEP Working Group on Asthma and Pregnancy. Management of asthma during pregnancy. Bethesda (MD): National Institutes of Health, 1993 Sep. Report no. 93-3279Google Scholar
  14. 14.
    NAEP report of the NAEPP Working Group. Considerations for diagnosing and managing asthma in the elderly. Bethesda (MD): National Institutes of Health, 1996 Feb. Report no. 96-3662Google Scholar
  15. 15.
    Sheffer AL, Buist AS, editors. Proceedings of the Asthma Mortality Task Force. J Allergy Clin Immunol 1987; 80 (3 Pt 2): 361–3Google Scholar
  16. 16.
    Haines A, Feder G. Guidance on guidelines. BMJ 1992; 305: 785–6PubMedCrossRefGoogle Scholar
  17. 17.
    Hayward RSA, Wilson MC, Tunis SR, et al. More information abstracts of articles describing clinical practice guidelines. Ann Intern Med 1993; 118: 731–7PubMedGoogle Scholar
  18. 18.
    Gibson P. Asthma guidelines and evidence-based medicine. Lancet 1993; 342: 1305PubMedCrossRefGoogle Scholar
  19. 19.
    Kohler CL, Davies SL, Bailey WC. How to implement an asthma education program. Clin Chest Med 1995; 16: 557–65PubMedGoogle Scholar
  20. 20.
    Zeiger RS, Heller S, Mellon MH. Facilitated referral to asthma specialist reduces relapses in asthma emergency room visits. J Allergy Clin Immunol 1991; 87: 1160–8PubMedCrossRefGoogle Scholar
  21. 21.
    Hirschfield EB. Practice parameters and the malpractice liability of physicians. JAMA 1990; 263: 1556–62CrossRefGoogle Scholar
  22. 22.
    Smith GH. Maine’s Liability Demonstration Project: relating liability to practice parameters. In: American Medical Association State Health Legislation Report. Chicago (IL): American Medical Association, 1990: 1–5Google Scholar
  23. 23.
    Lee TL. Beyond guidelines: can general internists show the (critical) paths? J Gen Intern Med 1996; 11: 174–5PubMedCrossRefGoogle Scholar
  24. 24.
    Hayward SAR, Wilson MC, Tunis SR, et al. Practice guidelines: what are internists looking for? J Gen Intern Med 1996; 11: 176–8PubMedCrossRefGoogle Scholar
  25. 25.
    Dales RE, Schweitzer I, Kerr P, et al. Risk factors for recurrent emergency department visits for asthma. Thorax 1995; 50: 520–4PubMedCrossRefGoogle Scholar
  26. 26.
    Feder G, Griffiths C, Highton C, et al. Do clinical guidelines introduced with practice based education improve care of asthmatic and diabetic patients? A randomized controlled trial in general practices in east London. BMJ 1995; 311: 1473–8PubMedCrossRefGoogle Scholar

Copyright information

© Adis International Limited 1997

Authors and Affiliations

  • Richard A. Nicklas
    • 1
    • 2
    • 3
  • Albert L. Sheffer
    • 4
    • 5
  1. 1.George Washington Medical CenterWashington D.C.USA
  2. 2.Uniformed Services University of Health SciencesBethesdaUSA
  3. 3.Center for Drug Evaluation and Research, Food and Drug AdministrationRockvilleUSA
  4. 4.Harvard Medical SchoolBostonUSA
  5. 5.Allergy SectionBrigham and Women’s HospitalChestnut Hill, BostonUSA

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