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IPCRG 2nd World Conference
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Program Highlights - Day 2
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Keynote 3
IPAG: New WHO Primary Care Guidelines for
Rhinitis, Asthma And COPD.
C.P. van Schayck
IPAG is an independent group of internationally recognized primary care specialists in the management of airways disease with strong links to primary care respiratory groups (such as IPCRG) and global primary care groups (WONCA). IPAG seeks endorsement and collaboration from external societies and specialists groups (ERS, EAACI).
The aim of IPAG is to deliver an internationally valid symptom based approach for the diagnosis and management of asthma, COPD and rhinitis which will assist in the implementation of the GINA, GOLD and ARIA guidelines in primary care. Based on GINA, GOLD and ARIA three (WHO) levels easily distinguished worldwide in primary care are assessed.
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Minimum: the minimum level for diagnosis and treatment which apply to all GPs no matter wat their limitations are in the conditions of work.
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Optimal (standard): achievable with standard facilities available for diagnosing and treatment.
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Ideal: achievable with unlimited resources in time, money and equipment for diagnosing and treatment.
The two main differences with GINA, GOLD and ARIA guidelines are:
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Diagnosis section which helps to make a differential diagnosis between asthma, COPD and rhinitis starting with respiratory complaints presented with the help of simple evidence-based and specially developed questionnaires.
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Management of asthma in children less than 6 years.
From February 2004 IPAG will be implemented under the umbrella of IPCRG and will be governed by a special guideline IPCRG committee.
Note: The IPAG guidelines were to be officially launched during the IPCRG conference in Melbourne. This launch will now follow WHO approval.
Prof. Dr. C.P. van Schayck
University of Maastricht Research Institute Caphri
P.O. Box 616 62000 MD Maastricht
Phone: +31 (0)43-3882152
Fax: +32 (0)43-3884225
Email: o.vanschayck@caphri.unimaas.nl
Keynote 4
Actions Required to Reduce the Burden of Asthma
in the Asia-Pacific Region
Richard Beasley
Medical Research Institute of New Zealand
Wellington, New Zealand
The burden of asthma within the Asia-Pacific region is considerable in terms of prevalence, morbidity, mortality and economic cost. It is likely that the burden will increase substantially over the next few decades, due to the predicted increase in asthma prevalence, as communities progressively adopt western lifestyles and become urbanised. Until there is a greater understanding of the factors that cause asthma, and novel public health and pharmacological measures become available to reduce the prevalence of asthma, the priority is to ensure that cost-effective management strategies are available to as many persons as possible with asthma in the region. This will require a broad range of initiatives including:
1. Recognition that asthma is an important cause of morbidity, economic cost and mortality within the region.
2. Identify and address the economic and political factors which limit the availability of health care.
3. Improve accessibility to essential drugs for the management of asthma in low income countries.
4. Identify and address the environmental factors including indoor and outdoor pollution which affect respiratory morbidity including that due to asthma.
5. Promote and implement anti-tobacco policies to reduce tobacco consumption.
6. Adaptation of international asthma guidelines to ensure they are practical and realistic in terms of different health care systems.
7. Integrate asthma guidelines with other respiratory guidelines for children and adults. In this respect, there is a requirement to merge the key elements of the different respiratory guidelines into an algorithm for use at the first point of entry of a respiratory patient’s contact with health services.
8. Develop dissemination strategies for the implementation of guidelines.
9. Promote cost-effective management approaches which have been proven to reduce morbidity and mortality, thereby ensuring optimal treatment is available to as many persons as possible with asthma.
10. Research the causation of asthma, primary and secondary intervention strategies, and management programmes relevant to the region.
Workshop 9
Spirometry
All guidelines recommend spirometry as the 'gold-standard' for the objective measurement of lung function in respiratory disease.
The aim of the workshop is to assist primary health care providers to:
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perform technically competent spirometry
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be able to interpret it at a level appropriate for primary care workers.
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Hands on performance of spirometry is undertaken as well as case analysis of normal and abnormal spirometry in the primary care setting. For a comprehensive
introduction to spirometry see the online
NAC
Spirometry Handbook |
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©IPCRG Melbourne 2004