Challenges for asthma units in response to COVID-19: a qualitative group dynamics analysis

Abstract

Objective

To develop a set of recommendations for the management of severe asthma during COVID-19 pandemic.

Methods

Eleven pneumologists and allergologists who were staff members of officially accredited asthma units in Catalonia (Spain) participated in a cross-section study based on three 2-hour virtual workshops (first: brainstorming, second: identification of impacts and challenges summarized in 10 topics, third: establishment of final recommendations by consensus).

Results

Impacts and challenges identified were improvement of referral protocols between different levels of care; assessment of the minimum number of function tests to be performed and promote the performance of spirometry in primary care; implementation of videoconferencing, mobile apps, telephone calls, or integral virtual platforms for the follow-up of patients, and definition of the model of care (face-to-face, telematics, mixed) according to the patient’s individual needs; self-administration of biologics for domiciliary treatment; and empowerment of the role of nursing and hospital pharmacy in particular for follow-up and self-administration of biologics. The main recommendations included coordination between primary care and specialized care consultation, optimization of lung function testing, implementation of telemedicine, and the role of nursing and hospital pharmacy.

Conclusion

The specific proposals in response to the effect of COVID-19 pandemic focused on four areas of interest (coordination between primary care and specialized care, optimization of lung function testing, implementation of telemedicine, and empowerment of the role of nursing and hospital pharmacy) may be generalized to other health care settings, and help to introduce new ways of caring asthma patients in the COVID-19 context.

Acknowledgements

The authors thank Marta Pulido, MD, PhD, for editing the manuscript and editorial assistance.

Disclosure statement

C. Martínez Rivera: personal fees as a speaker, scientific advisor, and participation in clinical studies from AstraZeneca, Chiesi, GlaxoSmithKline, Mundifarma, Novartis, and Teva; A. Crespo-Lessmann: personal fees from Novartis, Chiesi España, Laboratorios Esteve, Ferrer, Zambon, Boehringer Ingelheim, Bial, Teva, FAES Farma, and grants and persona fees AstraZeneca, ouside the submitted work; E. Arismendi: fees for training and consultancy from Astra-Zeneca, GSK, Chiesi, and Novartis; M. Muñoz-Esquerre: honoraria as a speaker, scientific advisor or participation in clinical studies from AstraZeneca, Chiesi, GlaxoSmithKline, Menarini, Mundifarma, Novartis, Ferrer and Teva; X. Aguilar: none to be declared; P. Ausín: personal fees as for training and consultancy by Astra-Zeneca, GSK, Chiesi, and Novartis; I. Bobolea: received honoraria from Novartis, GSK, Teva, Astra Zeneca, and Chiesi for speaking at symposia, member of advisory boards, and financial support from these companies for attending scientific symposia and other educational programs; G. Dalmau Duch: none to be declared; R. Pifarré Teixido: none to be declared; G. Sabater Talaverano: none to be declared; A. Sogo Sabardia: personal fees from GlaxoSmithKlein, Astra-Zeneca, Novartis, Allergy Therapeutics, Inmunotek, Diater, and Chiesi; and X. Muñoz Gall: honoraria as a speaker, scientific advisor or participation in clinical studies from AstraZeneca, Boehringer Ingelheim, Chiesi, Faes, GlaxoSmithKline, Menarini, Mundifarma, Novartis, and Teva.

Data availability statement

Data sharing: study data are available from the authors upon request.