How Asthma Guidelines Improve Asthma Awareness

It started in the mid-1980s. Asthma morbidity and mortality was increasing. This was despite improved asthma wisdom. It was also despite some great asthma medicines on the market. So, asthma experts got together. They formed panels. They created guidelines. All of this to improve asthma awareness.1-2

Here’s how they did it

What is our beginning?  Allow me to insert myself into this bit of history. Along with many other kids my age, I had high-risk asthma in 1985. I was fifteen. It was so bad my doctor didn’t know what to do to help me. So, he referred me to the experts at the asthma hospital in Denver. I was admitted to National Jewish Hospital/ National Asthma Center (now National Jewish). I was among many asthmatic kids admitted to 7-Goodman and 2-May.

But, it was expensive to house kids there.

My parents had a hard time dealing with their insurance. They had good insurance. In fact, their insurance agents even agreed to pay prior to me being admitted there. But, once they started getting the bills, these agents gave my parents a hard time. They did end up paying in the end. But, it was very stressful for my parents.

In total, in 1988, over $4 billion dollars was spent on asthma-related expenses.3 Money speaks. When a disease starts to get expensive, the powers that be open their eyes. And this, I think, is how the word about our disease started to get out. At the very least, this is how some of the world’s most renowned asthma experts realized that something had to be done.

So, what happened next?

National Jewish is a research hospital. There were other similar hospitals around the U.S. Doctors at these research centers had access to all the best asthma wisdom. My doctor at home was a regional doctor. Most regional doctors did not have the same wisdom as doctors at these research hospitals. So, various asthma experts got together during the mid-1980s in an effort to improve asthma awareness. Their goal was to educate regional doctors with the same wisdom learned by doctors at research hospitals.

This began by regional doctors visiting the research centers. Here, the most up-to-date asthma wisdom would be shared. And it worked. Regional doctors were better equipped to help their asthma patients. A problem with this is that doctors are busy people. So, most doctors simply didn't have the ability to travel long distances to learn how to best treat asthmatics. And this is what lead to the creation of the first asthma guidelines.

What are asthma guidelines?

They are guidelines meant to guide doctors on how best to help their asthmatic patients. The first guidelines were introduced in the early in 1989 and 1990.1 Since that time, some of these guidelines have been updated. Other guidelines have also been created, some of which are specific to certain countries. But, others are global initiatives to improve asthma awareness.

There are two asthma guidelines you’ll see me referencing quite a bit, and they are both global. One is the guidelines created by the National Heart, Blood, And Lung Instutute (NHLBI). They were last updated in 2007. Another are those created by the Global Initiative for Asthma (GINA). They were last updated in 2017.

I would imagine that different doctors have their own preference as to which guidelines are best. But, the goal of all of them is to guide physicians to the best strategies for managing their asthma patients. They “guide” doctors to helping their asthma patients obtain ideal asthma control.

So, what now?

In 2008, I had a conversation with the public relations person at National Jewish. She said that both 7-Goodman and 2-May were closed in the early 1990s. She said the reason was that regional doctors were educated. They had access to the same wisdom as doctors at National Jewish. They now have the ability to help all asthmatic obtain good asthma control. So, they no longer had a need to refer patients to the experts at research hospitals. And the reason, she said, was because of the publication of asthma guidelines.

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