A proposal for a practical treatment guideline designed for the initial two-hours of the management of patients with acute severe asthma and COPD using the principles of evidence-based medicine

Abstract 

We have proposed a clinical treatment guideline for the management of acute, severe asthma and chronic obstructive pulmonary disease (COPD) using the principles of evidence-based medicine. The content is based upon practical clinical issues in need of consensus. A previous study has shown that this particular area is in serious need of quality control. Based on a strict 2 h time schedule with a unified treatment plan for both asthma and COPD, it is possible to secure for the patients a well-documented medical therapy promoting decision-making and clarification of the patient within this time limit. A summary of the statements is presented in a one-page, user-friendly format in order to cope with the clinician's need of having access to published evidence quickly and easily. A website (www.phanareth.dk or a website provided by Respiratory Medicine) has been established providing regular updates. A strategy for the implementation and the evaluation process has been planned after the publication of this paper. We believe this approach to be an important step towards an increase in the quality of guidelines and also a tool to make “guideline writers” aware of the responsibility of making their recommendations work.

Keywords: asthma, COPD, evidence-based medicine, guideline, exacerbations, acute, severe, treatment.

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• f1 Correspondence should be addressed to: Klaus Phanareth, MD, PhD, Snogegårdsvej 99, 2820 Gentofte, Denmark. E-mail: phanareth@dadlnet.dk