Reasons for the gap between asthma in reality and Gina guidelines

Asthma is a common chronic disease worldwide, affecting 300 million people of all ages. In spite of the existence of scientifically proven clinical guidelines for the past 15 years and efficient controller medications, the gaps between asthma management in reality and the goals of the Global Initiative for Asthma (GINA) guidelines are huge. Asthma, being a chronic disease, might be a companion from early childhood to the end of life and, as such, may impose major obstacles in disease management. These obstacles may rise from patient coping skills and style, from reasons that depend on the general practitioner himself/herself and the medical establishment and, most probably, also from lack of agreement between patients and caregivers about what constitutes well-managed asthma. This review aims to reveal and clarify the known and possible reasons for the recently proven worldwide gaps that still exist between asthma in reality and the goals of asthma clinical guidelines. Presenting and discussing the reasons for these huge gaps will hopefully help general practitioners to close these gaps in order to improve their patients asthma related quality of life and preserve lung function throughout life and decrease morbidity.