Key recommendations for primary care from the 2022 Global Initiative for Asthma (GINA) update

Area of Science:

• Pulmonology
• Respiratory Medicine
• Clinical Practice Guidelines

Background:

• The Global Initiative for Asthma (GINA) was founded in 1993 to enhance worldwide asthma awareness, prevention, and management.
• GINA provides evidence-based, annually updated clinical resources, influencing national asthma guidelines globally.
• GINA operates independently of industry funding, relying on material sales and licensing.

Purpose of the Study:

• To review and summarize key practical guidance for primary care from the 2022 GINA strategy report.
• To provide updated recommendations on asthma diagnosis confirmation using spirometry or peak expiratory flow.
• To offer guidance on the diagnosis, investigation, optimization, and treatment of severe asthma for primary care.

Main Methods:

• Review of the 2022 GINA strategy report.
• Focus on practical guidance for primary care physicians.
• Inclusion of updated recommendations for managing mild, moderate, and severe asthma.

Main Results:

• GINA recommends inhaled corticosteroid (ICS)-containing therapy for most asthma patients to reduce severe exacerbations.
• For mild asthma in adults and adolescents, combination ICS-formoterol as needed is an option.
• Maintenance-and-reliever therapy (MART) with ICS-formoterol is the preferred regimen for moderate-severe asthma.
• Individualized assessment, adjustment, and review of asthma treatment are crucial.

Conclusions:

• The 2022 GINA strategy provides essential updates for primary care on asthma diagnosis and management.
• ICS-containing therapies are central to reducing asthma exacerbations across patient groups.
• Specific considerations are noted for implementing GINA guidance in low- and middle-income countries due to medication access issues.