Asthma is known as a chronic disease, and epidemiological studies indicate that its prevalence is increasing worldwide [1]. The reason for the rise in prevalence is not clear [2]. Asthma affects over 10% of children and over 5% of adults in many European countries, and imposes a large burden on health services provision [1]. In Iran asthma affects 4.2% of children [3] and 2.8% of adults [4]. Optimal management of asthma requires appropriate drug administration, avoidance of exacerbating factors, and patient education [5].
There is still debate about how asthma should be treated pharmacologically and at what stage anti-inflammatory therapy should be introduced [6]. Low use of as-required beta2-agonist (less than once a day), and using drugs with low risk of side-effects are important goals of asthma treatment. However, sensitive indices of asthma severity including quality-of-life measurements, measurement of bronchial reactivity, or a measure of airway inflammation may be accessible to some types of health care services in developing countries. Lack of easily accessible guidelines, some medications and perhaps spirometry in developing countries making it difficult to assess asthma severity and achievement of optimal treatment. Thus asthma symptoms are often underestimated, leading to inadequate therapy [3].
The goals of asthma treatment have been significantly altered in the new guidelines [5]. More attention is paid to patient satisfaction placing greater emphasis on quality of life goals and on the partnership between the patient and provider rather than the provider simply telling the patient what to do [6]. We have previously shown that asthmatic patients in Iran benefit poorly from asthma education programs designed to teach them to avoid risk factors and to administer drugs correctly (specially with inhalers) [3,4]. Other forms of education (e.g., proper use of inhalers, avoidance of aggravating factors, regular PEF measurements) did lead to significant improvement in asthma management [7-9].
In the present study, we examined the effect of adopting the Global Initiative Strategy for Asthma Management (GINA) to treat asthma patients in Iran on asthma symptoms (including wheezing) and spirometric measures of pulmonary function.