An explicit framework for tailoring treatment. The GINA report now draws a clear distinction between
population-level (e.g. national guidelines, health maintenance organisations) and patient-level treatment
decisions. The former are generally based on group mean data for symptoms, lung function and
exacerbations, as well as safety, availability and overall cost. By contrast, when choosing between options
for individual patients, clinicians should also take into account patient phenotype or characteristics that
may predict their risk of exacerbations and/or treatment response (e.g. age, smoking status, sputum
eosinophils if available), as well as patient preference, and practical issues of inhaler technique, adherence
and cost to the patient. The extent to which treatment can be tailored depends on local regulations and
access, and is limited at present by lack of long-term evidence in broad populations.