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Canadian Pediatric Asthma Consensus Guidelines, 2003 (updated to December 2004): Introduction

From the University of Manitoba, Winnipeg, Man. (Becker, Simons, Watson); the University of Montréal, Montréal, Que. (Bérubé, Thivierge); the University of Ottawa, Ottawa, Ont. (Chad, Kovesi, Reisman); McMaster University, Hamilton, Ont. (Dolovich, Sears); McGill University, Montréal, Que. (Ducharme, Ernst, Mazer); the University of Toronto, Toronto, Ont. (D'Urzo); the University of British Columbia, Vancouver, BC (Ferguson); the Health Sciences Centre, Winnipeg, Man. (Gillespie); Dalhousie University, Halifax, NS (Kapur, Pianosi); the University of Western Ontario, London, Ont. (Lyttle); the University of Calgary, Calgary, Alta. (Montgomery, Spier); the University of Southern Denmark, Kolding, Denmark (Pedersen); St. Michael's Hospital Toronto, Ont. (Zimmerman).

Correspondence to: Dr. Allan Becker, Section of Allergy and Clinical Immunology, Department of Pediatrics and Child Health, University of Manitoba AE101–820 Sherbrook St., Winnipeg MB R3A 1R9; fax 204 787-5040; becker{at}cc.umanitoba.ca

Background: Although guidelines for the diagnosis and management of asthma have been published over the last 15 years, there has been little focus on issues relating to asthma in childhood. Since the last revision of the 1999 Canadian asthma consensus report, important new studies, particularly in children, have highlighted the need to incorporate this new information into asthma guidelines.

Objectives: To review the literature on asthma published between January 2000 and June 2003 and to evaluate the influence of new evidence on the recommendations made in the Canadian Asthma Consensus Report, 1999 and its 2001 update with a major focus on pediatric issues.

Methods: Diagnosis of asthma in young children, prevention strategies, pharmacotherapy, inhalation devices, immunotherapy and asthma education were selected for review by small expert resource groups. In June 2003, the reviews were discussed at a meeting under the auspices of the Canadian Network For Asthma Care and the Canadian Thoracic Society. Data published up to December 2004 were subsequently reviewed by the individual expert resource groups.

Results: This report evaluates early life prevention strategies and focuses on treatment of asthma in children. Emphasis is placed on the importance of an early diagnosis and prevention therapy, the benefits of additional therapy and the essential role of asthma education.

Conclusion: We generally support previous recommendations and focus on new issues, particularly those relevant to children and their families. This guide for asthma management is based on the best available published data and the opinion of health care professionals including asthma experts and educators.

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