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History of Guidelines for the Diagnosis and Management of Asthma

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Abstract

The Global Initiative on Asthma (GINA) was launched in 1993 in collaboration with the National Heart, Lung, and Blood Institute, the National Institutes of Health (USA) and the WHO. Its first effort was the production of a consensus report on asthma treatment, which aimed to bridge the gap between the various treatment options and the incorporation and implementation of innovative treatment forms into daily clinical practice. The first report published in 1995, A Global Strategy for Asthma Management and Prevention, has been translated into several languages, widely adopted and provided the foundation for several asthma guidelines worldwide. The GINA and other guidelines were primarily based on consensus of expert opinion in order to employ a severity-based classification system as a guide to treatment. However, in the late 1990s, guidelines underwent a major paradigm shift from opinion- to evidence-based classification as the foundation for asthma management. A second major shift involved the classification of asthma according to the level of disease control as a guide to treatment, which was realized for the first time in the revised 2006 GINA guidelines. Since their first appearance, asthma guidelines have played a leading role in disseminating information about asthma. In addition, they have had a substantial impact on standardizing asthma care around the world, which is likely to continue in the future. This article addresses the history of guideline development and issues related to asthma guidelines, with particular emphasis on the GINA guidelines.

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Acknowledgements

No sources of funding were used to assist in the preparation of this review. Prof. Dr Kroegel has no conflicts of interest that are directly relevant to the content of this review. Dr Wirtz has received honoraria for speaking engagements from AstraZeneca, GSK, Nycomed and Boehringer-Ingelheim.

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  1. Department Pneumology and Allergy, Medical Clinics I, Friedrich-Schiller-University, Erlanger Allee 101, D-07740, Jena, Germany

    Claus Kroegel (Consultant Professor of Internal Medicine, Pneumology and Allergy)

  2. Medical Clinic and Policlinic I (Pneumology), University of Leipzig, Leipzig, Germany

    Hubert Wirtz

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Correspondence to Claus Kroegel.

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Kroegel, C., Wirtz, H. History of Guidelines for the Diagnosis and Management of Asthma. Drugs 69, 1189–1204 (2009). https://doi.org/10.2165/00003495-200969090-00004

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