The National Heart, Lung, and Blood Institute’s National Asthma Education and Prevention Program (NAEPP) developed updated guidelines in 2007. Its Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma, resulted from a relatively transparent, evidence-based review of the literature. The relevant evidence was ranked as follows:
The goal is to update recommendations for managing asthma long term and for managing exacerbations by focusing on four essential components of asthma care: assessment and monitoring, patient education, control of factors contributing to asthma severity, and pharmacologic treatments.
The goals25 of asthma therapy include reducing impairment and reducing risk.
Reducing impairment includes:
Figure 126 provides a framework for classifying patients and initiating treatment as appropriate. There are four levels of asthma severity: intermittent, mild persistent, moderate persistent, and severe persistent. The levels of asthma severity are based on the following components:
History of Asthma Guidelines27
The NAEPP’s Guidelines for the Diagnosis and Management of Asthma were first published in 1991 in a landmark report that redefined the commonly held views about asthma. The following lists the updates to the original report:
1989 – NHLBI establishes the NAEPP and convenes first expert panel.
1991 – Expert Panel Report (EPR): Guidelines for the Diagnosis and Management of Asthma (EPR)released.
1997 – Expert Panel Report 2: Guidelines for the Diagnosis and Management of Asthma (EPR-2)released.
2002 – Expert Panel Report: Guidelines for the Diagnosis and Management of Asthma—Update on Selected Topics 2002 (EPR-Update 2002) released.
2007 – Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma (EPR-3)released.
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