• Alan Kaplan, van Boven Job F M JFM Department of Clinical Pharmacy & Pharmacology, Groningen Research Institute for Asthma and COPD (GRIAC), University Medical Center Groningen, Unive, Dermot Ryan, Ioanna Tsiligianni, Sinthia Bosnic-Anticevich, and REG Adherence Working Group.
• Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
• J Allergy Clin Immunol Pract. 2021 Apr 1; 9 (4): 1516-1519.

AbstractIn 2019, it was reported that changes to asthma management reported in the Global Initiative for Asthma (GINA) "…might be considered the most fundamental changes in asthma management in 30 years." These changes refer to the recommendation that the treatment of asthma in adolescents and adults would no longer include short-acting ß2-agonist (SABA) only, but that people with asthma should receive either symptom-driven inhaled corticosteroids (ICS)-containing treatment (mild asthma) or daily ICS-containing treatment. The fundamental reason for this shift was driven by concerns about the risks and consequences associated with SABA-only treatment, the need to improve the day-to-day management of asthma symptoms to prevent exacerbations and emergent evidence. These recommendations have subsequently been reinforced and characterized in GINA 2020, and it is reasonable to say that they are significant, not only in terms of an asthma management framework but also as a management approach in practice. This opinion article specifically focuses on opportunities and challenges associated with the implementation of GINA 2020 in primary care practice that need to be recognized and addressed if the shift in asthma treatment paradigm is to be successfully implemented into day-to-day practice.Copyright © 2021. Published by Elsevier Inc.

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