Note to the Sixth Edition

It is a pleasure to present the sixth edition of the Asthma Management Handbook to health care practitioners. Like previous editions, the Asthma Management Handbook 2006 aims to help clinicians and other health professionals make changes in their practice based on sound evidence, and where evidence is lacking, the consensus opinion of Australian experts has been incorporated. The Handbook acknowledges the difficulties of providing organised care in the primary care setting and tries to provide practical strategies that will assist with diagnosis, ongoing management and patient education. While primarily aimed at GPs, the Handbook is also intended as a resource and teaching tool for community pharmacists, nurses, asthma educators, ambulance officers, consumer representatives and healthcare students.

This edition is the outcome of a long development process begun in January 2004, when the National Asthma Council Australia (NAC) surveyed GPs about their preferences for the next version of the Handbook. The results of that national survey confirmed that GPs still wanted a hard copy publication as well as a web version, and that they sought more information on issues such as allergy in asthma, comorbidities, combination therapies, and systematic care. In June 2004 the NAC convened a multidisciplinary steering committee of experts drawn from health professional bodies: The Thoracic Society of Australia and New Zealand, the Royal Australian College of General Practitioners, the Australasian Society of Clinical Immunology and Allergy, the Pharmaceutical Society of Australia, and from the Australian Asthma and Health Educators' Alliance.

The Guidelines Committee and other invited opinion leaders resolved that the new Asthma Management Handbook should not duplicate existing international guidelines, but build on completed work and provide an Australian context and focus. The group decided to use the GINA, British Thoracic Society (BTS/SIGN) and New Zealand asthma guidelines as a basis, along with a comprehensive literature search to provide subsequent evidence (from 2002 onwards). The search questions were developed to try to provide answers to previously unanswered questions of concern to GPs. This search concentrated on reviews and meta-analyses published in the Cochrane Database and major respiratory journals. The Asthma Management Handbook 2006 uses the NHMRC levels of evidence (I-IV), which are familiar to most Australian practitioners, supplemented by the tick symbol for practice points based on best practice consensus.

The Guidelines Committee oversaw the work of small ‘chapter working groups', each with at least two specialists and two GPs to maintain the focus on primary care and practicality. A modified SIGN process was used: working group leaders assessed the evidence and drafted the text, which was then reviewed by other working group members. Additional experts were invited to contribute in particular areas. In all, the Handbook writing and review team comprised over 60 contributors, assisted by two medical writers.

All chapters of the Handbook were internally peer-reviewed among the large group of contributors. The complete draft was then circulated to asthma stakeholder groups, including the NAC's member bodies, other professional organisations, and the pharmaceutical industry. All comments received were reviewed by the chapter working groups, and by the Guidelines Committee where required, before final amendments were made to the text. The Asthma Management Handbook 2006 has been endorsed by The Thoracic Society of Australia and New Zealand, The Royal Australian College of General Practitioners and the Australasian College for Emergency Medicine.

Professor Justin Beilby
Chairman
Guidelines Committee

Content Created (Thursday, 16 November 2006)