2020年国家哮喘教育和预防计划(NAEPP)更新和2021年全球哮喘倡议(GINA)的最新建议指导了基于证据的临床决策。然而,考虑到目前按年龄划分的健康状况,收入,和种族,没有进一步的指导,这些准则的公平执行和传播将是不可能的。该工作组报告回顾了新哮喘指南实施的现状,提供更新的循证治疗方案,关注特定患者人群,并解决了实施这些指导方针的障碍,边缘化,资源不足的社区。变态反应学家和免疫学家可以利用实用的方法来实现在整个生命周期中改善哮喘护理和高级哮喘护理的目标。对历史边缘化人群的具体考虑。指南实施的可修改障碍包括财务障碍,环境因素,以及过敏亚专科的准入和护理协调。改善基于指南的哮喘护理的各种计划包括社区计划,以学校为基础的哮喘项目,和数字健康解决方案,强调缩小种族差距。
The most recent recommendations from the 2020 National Asthma Education and Prevention Program Update and Global Initiative for Asthma 2021 guide evidence-based clinical decision making. However, given the present state of health disparities by age, income, and race, the equitable implementation and dissemination of these
guidelines will be unlikely without further guidance. This work group report reviews the current state of the new asthma
guideline implementation; presents updated evidence-based therapeutic options with attention to specific patient populations; and addresses barriers to the implementation of these
guidelines in minoritized, historically marginalized, and underresourced communities. Allergists and immunologists can use practical ways to accomplish the goals of improved asthma care access and advanced asthma care across the life span, with specific considerations to historically marginalized populations. Modifiable barriers to
guideline implementation include financial barriers, environmental factors, and allergy subspecialty access and care coordination. Various programs to improve access to
guideline-based asthma care include community programs, school-based asthma programs, and digital health solutions, with an emphasis on reducing disparities by race.