Diagnosis and Management of Difficult-to-treat and Severe Asthma

GINA has added an important addition to the resources that we offer to assist practitioners treating patients with asthma. A new Pocket Guide, “Diagnosis and Management of Difficult-to-treat and Severe Asthma in adolescent and adult patients” is now available on the GINA website, www.ginasthma-staging.c0db7pcn-liquidwebsites.com, and print copies may be ordered via the “Contact Us” form on the website. Embracing the issue of severe asthma was a critical goal for the GINA Board of Directors and Science Committee, as their mission remains focused on maximizing benefit for patients with asthma whilst minimizing healthcare provider burden.

2018 Difficult-to-treat and Severe Asthma — Free Download for Personal Use 2018 Difficult-to-treat and Severe Asthma — Purchase the E-Reader Version

Prof. Helen Reddel, Chair of the GINA Science Committee and a research leader at the Woolcock Institute of Medical Research in Sydney, Australia, stated “Difficult-to-treat and severe asthma are high priority issues because of the physical, emotional and financial burden for patients and their families, and the impact on primary and specialist healthcare systems. Clinicians in both low and high income countries need practical advice about how to assess and treat patients for whom conventional asthma therapies don’t seem to be working, and about how treatment strategies, including biologic therapies if available, can be implemented into patient care.”

The need for a practical resource addressing severe asthma was made apparent to the GINA Science Committee and Board of Directors from responses to a survey of members of the GINA Assembly, which is a group of physician volunteers around the world who actively disseminate GINA strategy in their respective countries. Two particular needs identified were (1) at what point should a patient be referred to a specialist, and (2) guidance for biologic therapies.


The goal of this Pocket Guide is to provide a practical summary for health professionals about how to identify, assess and manage difficult-to-treat and severe asthma in adolescents and adults. It is intended for use by general practitioners (GPs, primary care physicians), pulmonary specialists and other health professionals involved in the management of people with asthma.

The recommendations in this Pocket Guide were based on evidence where good quality systematic reviews or randomized controlled trials or, lacking these, robust observational data, were available, and on consensus by expert clinicians and researchers, where not. Development of the Pocket Guide and decision tree included extensive collaboration with experts in human-centered design to enhance the utility of these resources for end-users. This means translating existing high level lowcharts and text-based information to a more detailed visual format, and applying information architecture and diagramming principles.