The Lung Association

The Lung Association

March 25, 2010 12:18 ET

Canadian Thoracic Society Releases Updated Management Continuum to Help Patients Achieve and Maintain Asthma Control

OTTAWA, ONTARIO--(Marketwire - March 25, 2010) - The Canadian Thoracic Society (CTS) has released updated recommendations for the management of Asthma. The "Canadian Thoracic Society Asthma Management Continuum – 2010 Consensus Summary for children 6 years and over and adults" integrates new evidence into the management continuum, combining both pediatric and adult asthma (1).

Asthma is an inflammatory disorder of the airways characterized by paroxysmal or persistent symptoms such as dyspnea, chest tightness, wheezing, sputum production and cough, associated with variable airflow limitation and a variable degree of hyper-responsiveness of airways to endogenous or exogenous stimuli. Inflammation and its resultant effects on airway structure are considered the main mechanisms leading to the development and persistence of asthma (2).

Changes to the Management Continuum

The CTS asthma committee identified a need for an updated comprehensive management continuum diagram and as such, has addressed important key messages regarding asthma diagnosis and management in children (six years of age and over) and adults.

The revised continuum was modified to reflect the importance of insuring that the diagnosis is confirmed with objective assessment of lung function as well as regularly reassessing for asthma control using spirometry or peak expiratory flow (PEF).

Also addressed are the key medication and monitoring similarities and differences between pediatric and adult asthma management strategies.

The primary goal of asthma management is to achieve and maintain control of the disease in order to prevent exacerbations or minimize the risk for short- and long-term complications, morbidity and mortality.

Other key areas addressed in the 2010 recommendations include:

  • Symptoms suggestive of asthma in children (six years of age and over) and adults

  • Objective measures of pulmonary function supportive of an asthma diagnosis

  • Self-management education as a non-pharmacological approach

  • Pharmacological approaches:

    • Fast acting bronchodilators for use as needed to treat acute symptoms

    • Regular controller therapy for patients with one or more indicators of poor control based on their current asthma status and escalated as needed to gain control. Use of regular controller therapy should be after addressing other reasons for poor control and taking into account current control and future risk for severe exacerbations.

Implications of the 2010 Management Continuum update for clinical practice

The 2010 update emphasizes the importance of establishing an accurate diagnosis, typically by supplementing history and objective measures of lung function in individuals 6 years of age and over.

The updated Asthma Management Continuum and additional respiratory guidelines produced by the CTS can be found at the Canadian Respiratory Guidelines Website: http://www.respiratoryguidelines.ca/ under Guidelines and Standards.

About the Canadian Thoracic Society

The Canadian Thoracic Society (CTS), founded in 1958, is the medical section of The Canadian Lung Association. The CTS promotes lung health by supporting the respiratory community through leadership, collaboration, research, learning and advocacy and by promoting the best respiratory practices in Canada. It also advises The Canadian Lung Association on scientific matters.

Bibliography

(1) Lougheed MD, Lemiere C, Dell S, et al. Canadian Thoracic Society Asthma Management Continuum – 2010 Consensus Summary for children 6 years and over and adults. Can Respir J 2010; 17 (1).

(2) Boulet LP, Becker A, Bérubé D, Beveridge R, Ernst P. Canadian asthma consensus report, 1999. CMAJ 1999;161(11 suppl):S1-62.

Contact Information

  • The Lung Association
    Cameron Bishop
    Director of Government Affairs and Media Relations
    613-569-6411, ext, 223