Implementing the guidelines: What do you do when the rubber hits the road?

The National Asthma Education and Prevention Program Coordinating Committee Expert Panel Report 4 Working Group has issued a selected update to the 2007 National Asthma Education and Prevention Program guidelines based on predetermined questions. This rostrum provides an overview of the clinically important recommendations and a guide to practical issues that clinicians may face as they implement the working group's updated guidance. It also draws attention to areas in which the recommendations differ from those of the Global INitiative for Asthma. Factors that clinicians may wish to consider as they step up therapy in the continuum of care are elaborated, especially in areas in which the update does not provide sufficient information to make a recommendation.