CHEST CLINICAL COPD & ASTHMA IMMERSION PROGRAM - AUGUST 14, 2024-Maselli - Guideline (GINA & GOLD) Based Treatment

Maselli - Guideline (GINA & GOLD) Based Treatment_ Challenges and Pitfalls

Pdf Summary

The presentation by Dr. Diego J. Maselli focuses on the advantages and pitfalls of the Global Initiative for Asthma (GINA) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. These guidelines aim to provide evidence-based strategies for managing asthma and COPD on a global scale.<br /><br />**GINA Overview:**<br />- **Established:** 1993 in collaboration with the NHLBI, NHI, and WHO.<br />- **Objectives:** Increase asthma awareness, study environmental associations, reduce morbidity and mortality, improve asthma management, and make effective therapies more accessible.<br />- **Advantages:**<br />  - Updated annually.<br />  - Evidence-based, inclusive of adult and pediatric recommendations.<br />- **Disadvantages:**<br />  - Lack of clarity about conflicts of interest among committee members.<br />  - Lengthy (263 pages), possibly not widely known even by specialists.<br />  - Global recommendations may not be applicable to all countries.<br />- **Stepwise Management Plan:** Emphasizes using ICS-formoterol as a preferred controller and reliever, adjusting treatment based on symptom severity.<br /><br />**GOLD Overview:**<br />- **Established:** 1997 with partners such as NHLBI, NHI, and WHO.<br />- **Objectives:** Provide effective COPD management and prevention strategies, increase public awareness, study COPD-environment relationships, and implement effective diagnosis and prevention programs.<br />- **Advantages:**<br />  - Updated annually.<br />  - Evidence-based approach.<br />- **Disadvantages:**<br />  - Similar issues to GINA regarding conflict of interest transparency.<br />  - Lengthy (218 pages) and not widely known among specialists.<br /><br />**Key Points on Using GINA and GOLD:**<br />- Both documents serve as valuable resources for asthma and COPD management, based on comprehensive literature reviews and evidence-based practices.<br />- They are not strict guidelines but rather frameworks to inform and guide clinical decision-making.<br />- Annual updates ensure the inclusion of the latest research and treatments.<br /><br />**Conclusion:**<br />GINA and GOLD guidelines provide a structured approach to disease management but come with challenges like possible global inapplicability and document length. They offer a strong basis for evidence-based care but require further promotion and clarity regarding committee biases.

Keywords

GINA

GOLD

asthma

COPD

evidence-based

guidelines

management

ICS-formoterol

annual updates

conflict of interest

Chronic Obstructive Pulmonary Disease