HMN 2026: How Recommendations are developed for primary care asthma management in veterans, military members

In a synopsis of a clinical practice guideline issued by the U.S. Department of Veterans Affairs and U.S. Department of Defense and published online Feb. 17 in the Annals of Internal Medicine, updated recommendations are presented for the primary care management of asthma in veterans and military members.

Amir Sharafkhaneh, M.D., Ph.D., from the Michael E. DeBakey VA Medical Center in Houston, and colleagues present updated recommendations regarding evaluation and management of veterans and military members with asthma. Twelve key questions were developed, and 21 evidence-based recommendations were advanced following evaluation of the evidence.

The authors note that inhaled corticosteroids are strongly recommended; management of asthma is streamlined with recommendations of a combination of inhaled corticosteroids and rapid-onset long-acting ?-agonists as both reliever and controller agents, as well as step-up therapy by increasing inhaled corticosteroids and/or the addition of long-acting anticholinergic agents. Management of symptomatic gastroesophageal reflux disease and obesity are also supported for better control of asthma. Use of indoor air filtration devices is not suggested. Decision points are outlined for referral to a subspecialist.

“Asthma management within primary care is pivotal for enhancing patient outcomes and reducing health care burdens,” the authors write.

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