Chinese expert consensus on bronchial asthma control.

Abstract

Chinese and international guidelines for prevention and treatment of bronchial asthma (hereinafter referred to as asthma) indicate: the goal of asthma management is to achieve and maintain symptom control; treatment protocols need to be adjusted according to asthma control levels during asthma management; asthma management is a long-term process which incorporates three essential aspects—evaluation, treatment, and monitoring (1,2). These guidelines highlight that asthma control as the goal of treatment can be achieved by medication in the majority of patients, particularly with effective asthma management (1,2). The 2009 updates on the Global Initiative for Asthma (GINA) proposed a new conception of “overall asthma control”, which expanded the previous understanding of asthma control to emphasize the equal importance of achieving current asthma control and reducing future risk (3). However, a number of surveys in China and other countries have revealed that the rate of asthma control in the real world is far below as proposed by the guidelines (4-9). Poorly controlled asthma was shown to seriously affect the daily life, work and school of patients, and was associated with recurrent asthma exacerbations, unscheduled hospital visits and stay, and impaired lung functions, which eventually lead to increased treatment cost, lost productivity, as well as heavy social and economic burden (4-9). Therefore, with the updated understanding, efforts to improve the current pattern of asthma management and to reinforce the treatment strategies will have a long way to go for better outcomes of overall asthma control. In this regard, the Asthma Workgroup of Chinese Thoracic Society convened a panel meeting of experts in the related fields, which formed the following consensus. In order to guide clinical practicing, the present consensus was developed with reference to related guidelines and consensus documents published elsewhere, in particular, the important papers on asthma control that appeared in the recent years.