The Saudi initiative for asthma - 2012 update: Guidelines for the diagnosis and management of asthma in adults and children

Mohamed S Al-Moamary, Sami A Alhaider, Mohamed S Al-Hajjaj, Mohammed O Al-Ghobain, Majdy M Idrees, Mohammed O Zeitouni, Adel S Al-Harbi, Maha M Al Dabbagh, Hussain Al-Matar, Hassan S Alorainy, Mohamed S Al-Moamary, Sami A Alhaider, Mohamed S Al-Hajjaj, Mohammed O Al-Ghobain, Majdy M Idrees, Mohammed O Zeitouni, Adel S Al-Harbi, Maha M Al Dabbagh, Hussain Al-Matar, Hassan S Alorainy

Abstract

This an updated guidelines for the diagnosis and management of asthma, developed by the Saudi Initiative for Asthma (SINA) group, a subsidiary of the Saudi Thoracic Society. The main objective of SINA is to have updated guidelines, which are simple to understand and easy to use by non-asthma specialists, including primary care and general practice physicians. This new version includes updates of acute and chronic asthma management, with more emphasis on the use of Asthma Control Test in the management of asthma, and a new section on "difficult-to-treat asthma." Further, the section on asthma in children was re-written to cover different aspects in this age group. The SINA panel is a group of Saudi experts with well-respected academic backgrounds and experience in the field of asthma. The guidelines are formatted based on the available evidence, local literature, and the current situation in Saudi Arabia. There was an emphasis on patient-doctor partnership in the management that also includes a self-management plan. The approach adopted by the SINA group is mainly based on disease control as it is the ultimate goal of treatment.

Keywords: Asthma; Saudi Arabia; asthma control test; guidelines.

Conflict of interest statement

Conflict of Interest: None declared

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Pathophysiology of asthma
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Relevant questions in the diagnosis of asthma
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Asthma control test*
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Acceptable spirometry and significant bronchodilator response[303]
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List of equipotent daily doses in micrograms (μg) of the ICS available in Saudi market for adults
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List of equipotent daily doses in micrograms (μg) of the ICS available in the Saudi market for children
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The long-term goals of asthma management
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Outcomes of asthma education program
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Action plan for asthma based on the Saudi initiative for asthma in adults
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Initiation and maintenance of asthma therapy in stable patients based on the Saudi initiative for asthma in adults
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Assessing asthma control in adults
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Levels of severity of acute asthma exacerbations in adults
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Management of acute asthma in adults
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Adjustment of acute asthma treatment
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Diagnosis of asthma in children
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Modified asthma predicative index
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Choosing an inhaler device for children based on efficacy of drug delivery, cost-effectiveness, safety, ease of use, and convenience
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Levels of asthma control in children
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The test for respiratory and asthma control in kids “track” for kids

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The childhood asthma control test…

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The childhood asthma control test (c-act) for kids 4–12 years of age

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The childhood asthma control test (c-act) for kids 4–12 years of age

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Asthma management approach based on control for children

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Asthma management approach based on control for children

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The pediatric respiratory assessment measure score

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The pediatric respiratory assessment measure score

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Severity classification of asthma exacerbation based on PRAM score with corresponding risk of hospitalization

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Initial assessment in the emergency…

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Initial assessment in the emergency room based on PRAM assessment

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Initial assessment in the emergency room based on PRAM assessment

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Phase I of inpatient care…

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Phase I of inpatient care for asthma in children: Initial management

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Phase I of inpatient care for asthma in children: Initial management

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Phase II and III of…

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Phase II and III of inpatient care for asthma in children: Continuation of management
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References
    1. Al Frayh AR, Shakoor Z, Gad El Rab MO, Hasnain SM. Increased prevalence of asthma in Saudi Arabia. Ann Allergy Asthma Immunol. 2001;86:292–6. - PubMed
    1. Stewart WF, Ricci JA, Chee E, Morganstein D. Lost productive work time costs from health conditions in the United States: Results from the American Productivity Audit. J Occup Environ Med. 2003;45:1234–46. - PubMed
    1. Al-Mobeireek A. Prescribing for asthmatic children in primary care.Are we following the guidelines? Saudi Med J. 2003;24:1274. - PubMed
    1. Dashash NA, Mukhtar SH. Prescribing for asthmatic children in primary care. Are we following guidelines? Saudi Med J. 2003;24:507–11. - PubMed
    1. Al-Moamary MS, Al-Hajjaj MS, Idrees MM, Zeitouni MO, Alanezi MO, Al-Jahdal HH, et al. The Saudi Initiative for asthma. Ann Thorac Med. 2009;4:216–33. - PMC - PubMed
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Box 20
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The childhood asthma control test (c-act) for kids 4–12 years of age
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Box 21
Asthma management approach based on control for children

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The pediatric respiratory assessment measure…

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The pediatric respiratory assessment measure score

Box 22
The pediatric respiratory assessment measure score

Box 23

Severity classification of asthma exacerbation…

Box 23

Severity classification of asthma exacerbation based on PRAM score with corresponding risk of…

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Severity classification of asthma exacerbation based on PRAM score with corresponding risk of hospitalization

Box 24

Initial assessment in the emergency…

Box 24

Initial assessment in the emergency room based on PRAM assessment

Box 24
Initial assessment in the emergency room based on PRAM assessment

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Phase I of inpatient care…

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Phase I of inpatient care for asthma in children: Initial management

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Phase I of inpatient care for asthma in children: Initial management

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Phase II and III of…

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Phase II and III of inpatient care for asthma in children: Continuation of…

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Phase II and III of inpatient care for asthma in children: Continuation of management
All figures (26)
Box 22
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The pediatric respiratory assessment measure score
Box 23
Box 23
Severity classification of asthma exacerbation based on PRAM score with corresponding risk of hospitalization
Box 24
Box 24
Initial assessment in the emergency room based on PRAM assessment
Box 25
Box 25
Phase I of inpatient care for asthma in children: Initial management
Box 26
Box 26
Phase II and III of inpatient care for asthma in children: Continuation of management

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