The update of the treatment guide "Management of adult asthma in primary care" was initiated because five years had passed since the publication of the original guide. The procedure for updating treatment manuals is written in the "Estonian manual for the preparation of treatment manuals" (2020). At the first meeting, the Guideline Working Group reviewed the questions raised in the original guideline and found that some clinical questions regarding the pharmacological treatment of asthma (and possible comorbidities) may have added scientific evidence over time. They also wanted to review the organization of asthma treatment, as there have been changes in the Estonian healthcare system over the past five years. Until 2014, when the original treatment manual was drawn up, asthma treatment in Estonia began and a pulmonologist chose the further treatment tactics. As a result of the preparation of the treatment manual, family doctors could also start doing it. In 2017, the Estonian Health Insurance Fund conducted a clinical audit "Management of asthma in primary care" (1), which revealed that in at least two-thirds of cases (68%), family doctors still referred a patient with a primary diagnosis of asthma to a pulmonologist. This was mainly done to clarify the diagnosis, spirometry, or the reason for the referral did not appear in the medical records. This means that, over time, family doctors began to deal more with patients with or with suspected asthma, but the final diagnosis and/or treatment was often still made by a pulmonologist. One obstacle to the diagnosis of asthma may have been that spirometry was not available in many GP centres. In 2020, the Estonian Association of General Practitioners will deal with solving this problem, which has initiated a joint procurement for the purchase of spirographs for general practitioners. The clinical audit of the Health Insurance Fund revealed, among other things, that although the treatment manual recommended assessing the severity of asthma before starting pharmacological treatment, this had been done in only 4% of cases. In most of the patients, neither the family doctor nor the pulmonologist had determined the severity of the disease, although the severity of the disease depends on whether asthma treatment should be started with short-term therapy or a combination of short-term and long-term therapy. Since the audit showed that filling in the treatment documentation of patients with or suspected of asthma was incomplete, in some cases the severity of the disease could still be determined before starting the treatment and the treatment choices made could be justified. The purpose of updating the treatment manual is to ensure up-to-date optimal treatment of patients with asthma and suspected asthma in Estonia.