Key recommendations for primary care from the 2022 Global Initiative for Asthma (GINA) update

Mark L Levy, Leonard B Bacharier, Eric Bateman, Louis-Philippe Boulet, Chris Brightling, Roland Buhl, Guy Brusselle, Alvaro A Cruz, Jeffrey M Drazen, Liesbeth Duijts, Louise Fleming, Hiromasa Inoue, Fanny W S Ko, Jerry A Krishnan, Kevin Mortimer, Paulo M Pitrez, Aziz Sheikh, Arzu Yorgancıoğlu, Helen K Reddel

Research output: Contribution to journalReview articlepeer-review

Abstract / Description of output

The Global Initiative for Asthma (GINA) was established in 1993 by the World Health Organization and the US National Heart Lung and Blood Institute to improve asthma awareness, prevention and management worldwide. GINA develops and publishes evidence-based, annually updated resources for clinicians. GINA guidance is adopted by national asthma guidelines in many countries, adapted to fit local healthcare systems, practices, and resource availability. GINA is independent of industry, funded by the sale and licensing of its materials. This review summarizes key practical guidance for primary care from the 2022 GINA strategy report. It provides guidance on confirming the diagnosis of asthma using spirometry or peak expiratory flow. GINA recommends that all adults, adolescents and most children with asthma should receive inhaled corticosteroid (ICS)-containing therapy to reduce the risk of severe exacerbations, either taken regularly, or (for adults and adolescents with "mild" asthma) as combination ICS-formoterol taken as needed for symptom relief. For patients with moderate-severe asthma, the preferred regimen is maintenance-and-reliever therapy (MART) with ICS-formoterol. Asthma treatment is not "one size fits all"; GINA recommends individualized assessment, adjustment, and review of treatment. As many patients with difficult-to-treat or severe asthma are not referred early for specialist review, we provide updated guidance for primary care on diagnosis, further investigation, optimization and treatment of severe asthma across secondary and tertiary care. While the GINA strategy has global relevance, we recognize that there are special considerations for its adoption in low- and middle-income countries, particularly the current poor access to inhaled medications.

Original languageEnglish
Article number7
Pages (from-to)7
Journalnpj Primary Care Respiratory Medicine
Issue number1
Publication statusPublished - 8 Feb 2023

Keywords / Materials (for Non-textual outputs)

  • Adult
  • Child
  • Adolescent
  • Humans
  • Anti-Asthmatic Agents/therapeutic use
  • Asthma/diagnosis
  • Formoterol Fumarate/therapeutic use
  • Adrenal Cortex Hormones/therapeutic use
  • Administration, Inhalation
  • Primary Health Care


Dive into the research topics of 'Key recommendations for primary care from the 2022 Global Initiative for Asthma (GINA) update'. Together they form a unique fingerprint.

Cite this