Practical and evidence-based guidance for yellow zone medication escalation in adult asthma action plans: A clinical respiratory review
Rattachement africain : ca, us. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Asthma action plans (AAPs) are a cornerstone of asthma self-management support and are consistently associated with reduced exacerbations, improved quality of life and decreased health-care utilization in adults. However, their real-world uptake remains limited, with clinicians frequently citing uncertainty about how to operationalize appropriate medication escalation during acute loss of asthma control (the “yellow zone”). Since the original publication of the Canadian Thoracic Society-endorsed tool for yellow zone dose escalation, several new inhaler formulations, devices and combination therapies have entered the market. In addition, updated international guidelines and randomized controlled trial findings now converge on a strong recommendation to quadruple inhaled corticosteroid (ICS) doses as a strategy to prevent progression to severe exacerbation. This Clinical Respiratory Review synthesizes the evidence informing yellow zone instructions within AAPs and describes how we updated the point-of-care tool to accommodate new device types and therapeutic combinations. We briefly outline our approach to identifying relevant evidence, then summarize updated yellow zone escalation guidance for monotherapy ICS, ICS/long-acting beta-agonist (LABA), and ICS/LABA/long-acting muscarinic antagonist (LAMA) regimens across Canada, the United States and Europe, describing key pharmacologic principles and practical considerations such as dose-equivalence across devices, regulatory limits and safety data supporting short-term ICS escalation. Finally, we provide actionable advice for clinical practice and highlight priorities for future research.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Practical and evidence-based guidance for yellow zone medication escalation in adult asthma action plans: A clinical respiratory review
- Date Crossref
- 15/07/2026
- Éditeur
- Informa UK Limited
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Toronto Division of Respirology pays non établi dans la noticeUniversité ou école supérieure
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Women's College Hospital Division of Respirology pays non établi dans la noticeÉtablissement de santé
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Women's Hospital pays non établi dans la noticeÉtablissement de santé
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3M (United States) pays non établi dans la noticeEntreprise
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College of Family Physicians of Canada pays non établi dans la noticeInstitution
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St. Michael's Hospital pays non établi dans la noticeÉtablissement de santé
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Leslie Dan Faculty of Pharmacy pays non établi dans la noticeUniversité ou école supérieure
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The Keenan Research Centre in the Li Ka Shing Knowledge Institute of St Michael’s Hospital pays non établi dans la noticeStructure de recherche
Division of Respirology — University of Toronto, Division of Respirology — Women's College Hospital et Women's Hospital, avec 5 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.