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DISTRIBUTE OR COPY NOT DO ® MATERIAL- COPYRIGHTED GLOBAL STRATEGY FOR ASTHMA MANAGEMENT AND PREVENTION UPDATED 2010 © 2010 Global Initiative for Asthma DISTRIBUTE OR COPY NOT DO MATERIAL- COPYRIGHTED Global Strategy for Asthma Management and Prevention The GINA reports are available on www.ginasthma.org. Global Strategy for Asthma Management and Prevention 2010 (update) GINA EXECUTIVE COMMITTEE* GINA EXECUTIVE COMMITTEE* Eric D. Bateman, MD, Chair Mark FitzGerald, MD, Chair University Cape Town Lung Institute University of British Columbia Cape Town, South Africa Vancouver, BC, Canada Louis-Philippe Boulet, MD Neil Barnes, MD Hôpital Laval London Chest Hospital Sainte-Foy , Quebec, Canada London, England, UK Alvaro A. Cru , MD Peter J. Barnes, MD Federal University of Bahia National Heart and Lung Institute School of Medicine London, England, UK Salvador, Brazil Eric D. Bateman, MD Mark FitzGerald, MD University Cape Town Lung Institute University of British Columbia Cape Town, South Africa Vancouver, BC, Canada Allan Becker, MD Tari Haahtela, MD University of Manitoba Helsinki University Central Hospital Winnipeg, Manitoba, Canada Helsinki, Finland DISTRIBUTE OR Jeffrey M. Drazen, MD Mark L. Levy, MD Harvard Medical School University of Edinburgh Boston, Massachusetts, USA London England, UK COPY Robert F. Lemanske, Jr., M.D. Paul O’Byrne, MD University of Wisconsin School of Medicine NOT McMaster University Madison, Wisconsin, USA Ontario, Canada DO Paul O’Byrne, MD Ken Ohta, MD, PhD McMaster University Teikyo University School of Medicine Ontario, Canada Tokyo, Japan Ken Ohta, MD, PhD Pierluigi Paggiaro, MD MATERIAL- Teikyo University School of Medicine University of Pisa Tokyo, Japan Pisa, Italy Soren Erik Pedersen, M.D. Soren Erik Pedersen, M.D. Kolding Hospital Kolding Hospital Kolding, Denmark Kolding, Denmark Manuel Soto-Quiro, MD Emilio Pizichini, MD Hospital Nacional de Niños COPYRIGHTED Universidade Federal de Santa Catarina San José, Costa Rica Florianópolis, SC, Brazil Gary W. Wong, MD Helen K. Reddel, MD Chinese University of Hong Kong Woolcock Institute of Medical Research Hong Kong ROC Camperdown, NSW, Australia Sean D. Sullivan, PhD Professor of Pharmacy, Public Health University of Washington Seattle, Washington, USA Sally E. Wenzel, M.D. University of Pittsburgh Pittsburgh, Pennsylvania, USA *Disclosures for members of GINA Executive and Science Committees can be found at: http://www.ginasthma.com/Committees.asp?l1=7&l2=2 i PREFACE Asthma is a serious global health problem. People of all In spite of these dissemination efforts, international ages in countries throughout the world are affected by surveys provide direct evidence for suboptimal asthma this chronic airway disorder that, when uncontrolled, can control in many countries, despite the availability of place severe limits on daily life and is sometimes fatal. effective therapies. It is clear that if recommendations The prevalence of asthma is increasing in most countries, contained within this report are to improve care of people especially among children. Asthma is a significant burden, with asthma, every effort must be made to encourage not only in terms of health care costs but also of lost health care leaders to assure availability of and access to productivity and reduced participation in family life. medications, and develop means to implement effective asthma management programs including the use of During the past two decades, we have witnessed many appropriate tools to measure success. scientific advances that have improved our understanding of asthma and our ability to manage and control it In 2002, the GINA Report stated that “It is reasonable effectively. However, the diversity of national health to expect that in most patients with asthma, control care service systems and variations in the availability of the disease can, and should be achieved and of asthma therapies require that recommendations for maintained.” To meet this challenge, in 2005, Executive asthma care be adapted to local conditions throughout Committee recommended preparation of a new report the global community. In addition, public health officials not only to incorporate updated scientific information require information about the costs of asthma care, how but to implement an approach to asthma management DISTRIBUTE to effectively manage this chronic disorder, and education based on asthma control, rather than asthma severity. methods to develop asthma care services and programs Recommendations to assess, treat and maintain asthma OR responsive to the particular needs and circumstances control are provided in this document. The methods used within their countries. to prepare this document are described in the Introduction. COPY In 1993, the National Heart, Lung, and Blood Institute It is a privilege for me to acknowledge the work of the collaborated with the World Health Organization to many people who participated in this update project, as NOT convene a workshop that led to a Workshop Report: well as to acknowledge the superlative work of all who DO Global Strategy for Asthma Management and Prevention. have contributed to the success of the GINA program. This presented a comprehensive plan to manage asthma with the goal of reducing chronic disability and premature The GINA program has been conducted through deaths while allowing patients with asthma to lead unrestricted educational grants from AstraZeneca, productive and fulfilling lives. MATERIAL- Boehringer Ingelheim, Chiesi Group, GlaxoSmithKline, Meda Pharma, Merck, Sharp & Dohme, Mitsubishi Tanabe At the same time, the Global Initiative for Asthma (GINA) Pharma, Novartis, Nycomed, PharmAxis and Schering- was implemented to develop a network of individuals, Plough. The generous contributions of these companies organizations, and public health officials to disseminate assured that Committee members could meet together information about the care of patients with asthma while to discuss issues and reach consensus in a constructive at the same time assuring a mechanism to incorporate and timely manner. The members of the GINA Committees the results of scientific investigations into asthma are, however, solely responsible for the statements and COPYRIGHTED care. Publications based on the GINA Report were conclusions presented in this publication. prepared and have been translated into languages to promote international collaboration and dissemination of GINA publications are available through the Internet information. To disseminate information about asthma (http://www.ginasthma.org). care, a GINA Assembly was initiated, comprised of asthma care experts from many countries to conduct workshops with local doctors and national opinion leaders and to hold seminars at national and international meetings. In addition, GINA initiated an annual World Asthma Day (in 2001) which has gained increasing attention each year to raise awareness about the burden of asthma, and to initiate activities at the local/national level to educate Eric Bateman, MD families and health care professionals about effective Chair, GINA Executive Committee methods to manage and control asthma. University of CapeTown Lung Institute Cape Town, South Africa ii
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