Поточний перегляд GINA (основні положення) для дорослих та особливості ведення хворих на бронхіальну астму в умовах соціальних катастроф

Abstract

Abstract. The main document that forms the basis of international and national guidelines for the management of patients with bronchial asthma (BA) — the Global Initiative for the Management of Patients with Bronchial Asthma (GINA) — is revised every year. The clarifications of the current year concern both the diagnosis of primary asthma and the confirmation of this diagnosis in patients, who already receive controller therapy. The diagnostic algorithm for patients already receiving control therapy is presented (approaches for initial diagnosis and for diagnosis verification in patients on basic control therapy are different). Emphasis is placed on the need to carry out functional pulmonary tests in the diagnosis and monitoring of asthma patients, their high informativeness. There is an ongoing debate and calls for its continuation regarding the definition of severity of asthma, especially mild. Asthma treatment pathways (Tracks) are clearly defined, they are distinguished by drugs that are used to relieve symptoms (if necessary): fixed combinations of low-dose inhaled corticosteroids with formoterol — Track 1, or short-acting beta2 -agonists — Track 2. Emphasis is placed on the role of education and self management of patients with BA in conditions of limited access to medical care. Providing an agreed, written, personalized action plan that advises on the use of basic therapy, recognition of signs of worsening, and what appropriate interventions the patient can take on their own is a critical component of effective asthma self-management. Effective implementation requires a whole system approach that combines the active involvement of patients in training with the motivation of professionals who have to conduct this training and monitor its process. Our task is to bring this information to the widest circles of doctors and asthma patients, to widely implement patient education and self-management skills. Key words: bronchial asthma, medical care, treatment, difficult life situations, emergency, crisis