Review of the NAEPP 2007 Expert Panel Report (EPR-3) on Asthma Diagnosis and Treatment Guidelines

BACKGROUND: In 1989, the National Asthma Education and Prevention Program (NAEPP) convened an expert panel to develop a report that would provide a general approach to the treatment of asthma. Expert Panel Report: Guidelines for the Diagnosis and Management of Asthma, or EPR-1, was published in 1991 and was subsequently updated with 2 other reports, EPR-2 in 1997 and the EPR update in 2002. Advances in science and a greater understanding of the pathophysiology of asthma prompted the NAEPP to convene a 3rd expert panel in 2004. After nearly 3 years of work, Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma Full Report 2007, or EPR-3, was released on August 29, 2007. EPR-3 update from the NAEPP provides health care professionals with new information to improve the care of patients with asthma, including (1) more comprehensive discussion of asthma severity with expanded descriptions of impairment and risk, (2) increased focus on asthma control as a goal of therapy, and (3) expanded discussion of pharmacologic therapy for asthma with updated treatment algorithms. OBJECTIVES: To (1) extract key educational messages from the EPR-3 update that effectively summarize the appropriate management of the patient with asthma and (2) provide supporting literature to substantiate the development of these educational messages. METHODS: A consensus meeting of 9 asthma experts (4 pharmacists and 5 physicians) was held to discuss the EPR-3 update and condense its content into a usable format for the health care professional. Experts were selected on the basis of several criteria, including (1) affiliation with the NAEPP, (2) expertise in asthma management, and (3) familiarity with managed care processes. The author served as the 10th member and moderator of the meeting. RESULTS: Thorough review of the EPR-3 update resulted in the development of 7 key educational messages that can assist the health care professional in improving the management of the patient with asthma. Each educational message is presented with supporting literature to substantiate its distinction as a key point to be referenced when developing protocols for asthma management within managed care organizations. CONCLUSIONS: The complexity of asthma and its treatment has necessitated the development of several guidelines from the NAEPP, with the most recent EPR-3 update being released in late August 2007. One expert consensus has distilled the EPR-3 document into 7 key educational messages that can assist the health care professional in improving the care of the patient with asthma.