AAAAI Coverage - Reaching a consensus in asthma care
Rhythmic jazz music and the sweet scent of flowers filled the Philadelphia Convention center during my last visit for the Philadelphia Flower Show. This time, the sniffling was the same-blame it on Philadelphia's late winter weather-but the topic, pediatric asthma, generated more serious dialogue.
Health care professionals gathered in the ballroom for the public airing of the EAACI and the AAAAI's PRACTALL Diagnosis and Treatment of Pediatric Asthma. The document discusses diagnosis through spirometry, exercise challenges, and questions tailored to age groups. It also addresses treatment considerations such as airborne allergen avoidance, pharmacotherapy, and educational programs. The session drew crowds of health professionals curious about the document released just eight weeks ago.
Among those inquiring about allergy avoidance and drug side effects, one woman voiced a question that seemed to be on everybody's lips.
How do we balance these new guidelines with GINA and U.S. guidelines, asked Nancy from San Diego, Calif.
"Guidelines are guidelines, they were never intended to be a straight jacket," said session moderator Anthony J. Frew, MD, FAAAAI, Department of Respiratory Medicine, Brighton General Hospital, United Kingdom.
In an interview following the session, Leonard B. Bacharier, MD, FAAAAI, Department of Pediatrics, Washington University, St Louis, MO put it a little differently.
These are not intended to serve as guidelines, said Dr. Bacharier, but rather a consensus document. As with all elements of medicine, consensus does not always mean unanimity, he added.
Diagnosis and treatment vary greatly between countries and even doctors, Ulrich Wahn, MD, PRACTALL chairman and head of the Department of Paediatric Pneumology and Immunology, at Charité-Humboldt University, Berlin, Germany, had said during the session. The same patient might be prescribed immunotherapy in Germany, sublingual immunotherapy in Paris, receive no diagnosis in London and be treated with leukotriene receptors in the United States, he said.
This document reflects those differences, said Dr. Bacharier, and points thoughtful clinicians down a road of further inspection and research.