4 Step Approach to Asthma

PDF file download the PDF

It is internationally recommended that asthma be managed with a 4 step standardised approach to diagnosis and treatment (Global Initiative for Asthma - GINA)¹. Dosage of medicine is adjusted to match symptoms and lung function. Patients who respond well to treatment can then control their asthma using less medicine.

From the GINA guidelines, The Union produced an adapted version for low and middle-income settings². The Union uses low-cost essential medicines in its 4 step approach, with a package of technical measures for asthma management in the general health services.

Implementing The Union’s Asthma Guide has been shown in low and middle-income settings to reduce the severity of asthma for the majority of patients. This also stops money being wasted. Far less medicine is needed and the extremely costly emergency visits and hospitalisations are almost eliminated.

  1. Global strategy for asthma management and prevention. Bethesda, MD: National Institutes of Health. National Heart, Lung and Blood Institute. Revised 2006. www.ginasthma.com
  2. Ait-Khaled N, Enarson D. Management of asthma. A guide to the essentials of good clinical practice. 2nd edition. Paris, France, International Union Against Tuberculosis and Lung Disease, 2005 (3rd edition being finalised and available on this website in late 2007).
  3. Aït-Khaled N, Enarson DA et al. Treatment outcome of asthma after one year follow-up in health centres of several developing countries. Int J Tuberc Lung Dis. 2006 Aug;10(8):911-6.

The Union strongly recommends the use of CFC-free medicines. However, if you are still using CFC-containing products, click here to view the 4 step approach to asthma with CFC-containing inhalers.

Return to Top