[The practice guideline 'Asthma in adults' (second revision) from the Dutch College of General Practitioners; a response from the perspective of pulmonology]

Abstract

The second revised guideline 'Asthma in adults' from the Dutch College of General Practitioners describes the current approach to the diagnosis and treatment of patients with asthma. An interesting change to the guideline is the recommended use of combination medications. The guideline includes new insights into the relationship between peripheral airway inflammation and the clinical severity of asthma. Inhaled corticosteroids with smaller particles are thought to be more effective than traditional corticosteroids. The revised guideline contains recommendations for reducing the local side-effects associated with inhaled corticosteroids. For patients with persistent symptoms despite inhaled medication, a new algorithm can help to determine why symptoms persist before adjusting the medication.