The most fundamental change in asthma management in 30 years is currently happening. The Global Initiative for Asthma (GINA) no longer recommends treating asthma in adults and adolescents with short-acting bronchodilators alone. Instead, they should receive a symptom-driven (in mild asthma) or daily corticosteroid-containing inhaler, to reduce the risk of severe exacerbations.1
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Competency standards addressed (2016): 1.1, 1.5, 2.2, 3.5
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For patients with mild asthma, GINA recommends as-needed low-dose inhaled corticosteroid (ICS)/formoterol as the preferred option to prevent exacerbations and control symptoms. Australian guidelines are currently under review.
Evidence from recently published large 52-week studies, shows as-needed ICS/ formoterol controls mild asthma symptoms better than as-needed short acting beta2 agonist (SABAs), substantially reduces exposure to ICS compared to low-dose maintenance ICS, and reduces the risk of severe exacerbations.2,3,4
In Australia, the registered indication for budesonide/formoterol (Symbicort) was updated in July 2019 for the treatment of asthma to achieve overall asthma control, including the relief of symptoms and the redu
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