Consensus on mild asthma management: results of a modified Delphi study

References

• Global Initiative for Asthma. Global strategy for asthma management and prevention. Global Initiative for Asthma (GINA); 2021. https://ginasthma.org/gina-reports/ [last accessed 7 September 2021].
   Google Scholar
• Dusser D, Montani D, Chanez P, de Blic J, Delacourt C, Deschildre A, Devillier P, Didier A, Leroyer C, Marguet C, et al. Mild asthma: an expert review on epidemiology, clinical characteristics and treatment recommendations. Allergy. 2007;62(6):591–604. doi:10.1111/j.1398-9995.2007.01394.x.
   PubMed Web of Science ®Google Scholar
• Rabe KF, Adachi M, Lai CKW, Soriano JB, Vermeire PA, Weiss KB, Weiss ST. Worldwide severity and control of asthma in children and adults: the global asthma insights and reality surveys. J Allergy Clin Immunol. 2004;114(1):40–47.
   PubMed Web of Science ®Google Scholar
• Mulgirigama A, Barnes N, Fletcher M, Pedersen S, Pizzichini E, Tsiligianni I. A review of the burden and management of mild asthma in adults - implications for clinical practice. Respir Med. 2019;152:97–104. doi:10.1016/j.rmed.2019.04.024.
   PubMed Web of Science ®Google Scholar
• FitzGerald JM, Barnes PJ, Chipps BE, Jenkins CR, O’Byrne PM, Pavord ID, Reddel HK. The burden of exacerbations in mild asthma: a systematic review. ERJ Open Res. 2020;6(3):00359-2019. doi:10.1183/23120541.00359-2019.
   PubMedGoogle Scholar
• Krishnan JA, Cloutier MM, Schatz M. National Asthma Education and Prevention Program 2020 guideline update: where do we go from here? Am J Respir Crit Care Med. 2021;203(2):164–167.
   PubMed Web of Science ®Google Scholar
• Ding B, Small M. Disease burden of mild asthma: findings from a cross-sectional real-world survey. Adv Ther. 2017;34(5):1109–1127.
   PubMed Web of Science ®Google Scholar
• Suruki RY, Daugherty JB, Boudiaf N, Albers FC. The frequency of asthma exacerbations and healthcare utilization in patients with asthma from the UK and USA. BMC Pulm Med. 2017;17(1):74.
   PubMed Web of Science ®Google Scholar
• Royal College of Physicians. Why asthma still kills: the National Review of Asthma Deaths (NRAD) Confidential Enquiry report; 2014. http://www.rcplondon.ac.uk/sites/default/files/why-asthma-still-kills-full-report.pdf [last accessed 7 September 2021].
   Google Scholar
• Busse WW, Fang J, Marvel J, Tian H, Altman P, Cao H. Uncontrolled asthma across GINA treatment steps 2 - 5 in a large US patient cohort. J Asthma. 2021:1–13. doi:10.1080/02770903.2021.1897834.
   PubMed Web of Science ®Google Scholar
• The British Thoracic Society. BTS/SIGN British guideline on the management of asthma; 2019. https://www.brit-thoracic.org.uk/standards-of-care/guidelines/btssign-british-guideline-on-the-management-of-asthma/ [last accessed 7 September 2021].
   Google Scholar
• Cloutier MM, Baptist AP, Blake KV, Brooks EG, Bryant-Stephens T, DiMango E, Dixon AE, Elward KS, Hartert T, Krishnan JA, et al. 2020 focused updates to the asthma management guidelines: a report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group. J Allergy Clin Immunol. 2020;146(6):1217–1270. doi:10.1016/j.jaci.2020.10.003.
   PubMed Web of Science ®Google Scholar
• Busse WW, Pedersen S, Pauwels RA, Tan WC, Chen YZ, Lamm CJ, O’Byrne PM, START Investigators Group. The inhaled steroid treatment as regular therapy in early asthma (START) study 5-year follow-up: effectiveness of early intervention with budesonide in mild persistent asthma. J Allergy Clin Immunol. 2008;121(5):1167–1174. doi:10.1016/j.jaci.2008.02.029.
   PubMed Web of Science ®Google Scholar
• O’Byrne PM, Pedersen S, Lamm CJ, Tan WC, Busse WW. START Investigators Group. Severe exacerbations and decline in lung function in asthma. Am J Respir Crit Care Med. 2009;179(1):19–24. doi:10.1164/rccm.200807-1126OC.
   PubMed Web of Science ®Google Scholar
• Bårnes CB, Ulrik CS. Asthma and adherence to inhaled corticosteroids: current status and future perspectives. Respir Care. 2015;60(3):455–468. doi:10.4187/respcare.03200.
   PubMed Web of Science ®Google Scholar
• Bellamy D, Harris T. Poor perceptions and expectations of asthma control: results of the International Control of Asthma Symptoms (ICAS) survey of patients and general practitioners. Prim Care Respir J. 2005;14(5):252–258.
   PubMedGoogle Scholar
• Barnes PJ, Szefler SJ, Reddel HK, Chipps BE. Symptoms and perception of airway obstruction in asthmatic patients: clinical implications for use of reliever medications. J Allergy Clin Immunol. 2019;144(5):1180–1186. doi:10.1016/j.jaci.2019.06.040.
   PubMed Web of Science ®Google Scholar
• O’Byrne PM, FitzGerald JM, Bateman ED, Barnes PJ, Zhong N, Keen C, Jorup C, Lamarca R, Ivanov S, Reddel HK. Inhaled combined budesonide-formoterol as needed in mild asthma. N Engl J Med. 2018;378(20):1865–1876.
   PubMed Web of Science ®Google Scholar
• Bateman ED, Reddel HK, O’Byrne PM, Barnes PJ, Zhong N, Keen C, Jorup C, Lamarca R, Siwek-Posluszna A, FitzGerald JM. As-needed budesonide-formoterol versus maintenance budesonide in mild asthma. N Engl J Med. 2018;378(20):1877–1887. doi:10.1056/NEJMoa1715275.
   PubMed Web of Science ®Google Scholar
• Domingo C, Rello J, Sogo A. As-needed ICS-LABA in mild asthma: what does the evidence say? Drugs. 2019;79(16):1729–1737. doi:10.1007/s40265-019-01202-0.
   PubMed Web of Science ®Google Scholar
• Beasley R, Holliday M, Reddel HK, Braithwaite I, Ebmeier S, Hancox RJ, Harrison T, Houghton C, Oldfield K, Papi A, et al. Controlled trial of budesonide-formoterol as needed for mild asthma. N Engl J Med. 2019;380(21):2020–2030. doi:10.1056/NEJMoa1901963.
   PubMed Web of Science ®Google Scholar
• Hardy J, Baggott C, Fingleton J, Reddel HK, Hancox RJ, Harwood M, Corin A, Sparks J, Hall D, Sabbagh D, et al. Budesonide-formoterol reliever therapy versus maintenance budesonide plus terbutaline reliever therapy in adults with mild to moderate asthma (PRACTICAL): a 52-week, open-label, multicentre, superiority, randomised controlled trial. Lancet. 2019;394(10202):919–928. doi:10.1016/S0140-6736(19)31948-8.
   PubMed Web of Science ®Google Scholar
• Nakamura Y, Tamaoki J, Nagase H, Yamaguchi M, Horiguchi T, Hozawa S, Ichinose M, Iwanaga T, Kondo R, Nagata M, et al. Japanese guidelines for adult asthma 2020. Allergol Int. 2020;69(4):519–548.
   PubMed Web of Science ®Google Scholar
• Spanish guide for asthma management (GEMA) 5.0; 2020. https://www.gemasma.com/ [last accessed 7 September 2021].
   Google Scholar
• Yang CL, Hicks EA, Mitchell P, Licskai C, Dell SD, Rowe BH, Fitzgerald M, Leigh R, Watson W, Boulet LP. 2021 Canadian Thoracic Society guideline – a focused update on the management of very mild and mild asthma. Can J Respir Crit Care Sleep Med. 2021;5(4):205–245. doi:10.1080/24745332.2021.1877043.
   Web of Science ®Google Scholar
• Kawamatawong T, Sangasapaviriya A, Saiphoklang N, Oer-Areemitr N, Sriprasart T, Kamalaporn H, Amnuaypattanapon K, Rerkpattanapipat T, Chirakalwasan N, Kulpraneet M, et al. Guidelines for the management of asthma in adults: evidence and recommendations. Asian Pac J Allergy Immunol. 2021. doi:10.12932/AP-210421-1118.
   Web of Science ®Google Scholar
• Boulkedid R, Abdoul H, Loustau M, Sibony O, Alberti C. Using and reporting the Delphi method for selecting healthcare quality indicators: a systematic review. PLoS One. 2011;6(6):e20476. doi:10.1371/journal.pone.0020476.
   PubMed Web of Science ®Google Scholar
• Thompson M. Considering the implication of variations within Delphi research. Fam Pract. 2009;26(5):420–424. doi:10.1093/fampra/cmp051.
   PubMed Web of Science ®Google Scholar
• Hasson F, Keeney S, McKenna H. Research guidelines for the Delphi survey technique. J Adv Nurs. 2000;32(4):1008–1015.
   PubMed Web of Science ®Google Scholar
• Beiderbeck D, Frevel N, von der Gracht HA, Schmidt SL, Schweitzer VM. Preparing, conducting, and analyzing Delphi surveys: cross-disciplinary practices, new directions, and advancements. MethodsX. 2021;8:101401. doi:10.1016/j.mex.2021.101401.
   PubMed Web of Science ®Google Scholar
• Slade SC, Dionne CE, Underwood M, Buchbinder R. Standardised method for reporting exercise programmes: protocol for a modified Delphi study. BMJ Open. 2014;4(12):e006682. doi:10.1136/bmjopen-2014-006682.
   PubMed Web of Science ®Google Scholar
• Diamond IR, Grant RC, Feldman BM, Pencharz PB, Ling SC, Moore AM, Wales PW. Defining consensus: a systematic review recommends methodologic criteria for reporting of Delphi studies. J Clin Epidemiol. 2014;67(4):401–409. doi:10.1016/j.jclinepi.2013.12.002.
   PubMed Web of Science ®Google Scholar
• Vogel C, Zwolinsky S, Griffiths C, Hobbs M, Henderson E, Wilkins E. A Delphi study to build consensus on the definition and use of big data in obesity research. Int J Obes (Lond). 2019;43(12):2573–2586. doi:10.1038/s41366-018-0313-9.
   PubMed Web of Science ®Google Scholar
• Larenas-Linneman D, Salas-Hernández J, Del Río-Navarro BE, Luna-Pech JA, Navarrete-Rodríguez EM, Gochicoa L, Cano-Salas MC, García-Ramírez UN, López-Estrada C, Ortega-Martell JA, et al. Manejo Integral del Asma. Lineamientos para México (Mexico Asthma Guidelines). Rev Alerg Mex. 2021;68(Suppl 1):s1–s122.
   PubMedGoogle Scholar
• Shiba K, Kasahara K, Nakajima H, Adachi M. Structural changes of the airway wall impair respiratory function, even in mild asthma. Chest. 2002;122(5):1622–1626. doi:10.1378/chest.122.5.1622.
   PubMed Web of Science ®Google Scholar
• Chetta A, Foresi A, Del Donno M, Bertorelli G, Pesci A, Olivieri D. Airways remodeling is a distinctive feature of asthma and is related to severity of disease. Chest. 1997;111(4):852–857. doi:10.1378/chest.111.4.852.
   PubMed Web of Science ®Google Scholar
• Sandström T. Effects of pharmacological and non-pharmacological interventions. Clin Respir J. 2010;4 (Suppl 1):41–48. doi:10.1111/j.1752-699X.2010.00196.x.
   PubMed Web of Science ®Google Scholar
• The Childhood Asthma Management Program Research Group. Long-term effects of budesonide or nedocromil in children with asthma. N Engl J Med. 2000;343:1054–1063.
   PubMed Web of Science ®Google Scholar
• Haahtela T, Järvinen M, Kava T, Kiviranta K, Koskinen S, Lehtonen K, Nikander K, Persson T, Selroos O, Sovijärvi A. Effects of reducing or discontinuing inhaled budesonide in patients with mild asthma. N Engl J Med. 1994;331(11):700–705. doi:10.1056/NEJM199409153311103.
   PubMed Web of Science ®Google Scholar
• Boulet LP. Asymptomatic airway hyperresponsiveness: a curiosity or an opportunity to prevent asthma? Am J Respir Crit Care Med. 2003;167(3):371–378. doi:10.1164/rccm.200111-084PP.
   PubMed Web of Science ®Google Scholar
• Woolcock AJ. What are the important questions in the treatment of asthma? Clin Exp Allergy Rev. 2001;1(2):62–64. doi:10.1046/j.1472-9725.2001.00007.x.
   Google Scholar
• Bergeron C, Tulic MK, Hamid Q. Airway remodelling in asthma: from benchside to clinical practice. Can Respir J. 2010;17(4):e85–e93. doi:10.1155/2010/318029.
   PubMed Web of Science ®Google Scholar
• Harmsen L, Ulrik CS, Porsbjerg C, Thomsen SF, Holst C, Backer V. Airway hyperresponsiveness and development of lung function in adolescence and adulthood. Respir Med. 2014;108(5):752–757.
   PubMed Web of Science ®Google Scholar
• Jayaram L, Pizzichini MM, Cook RJ, Boulet LP, Lemière C, Pizzichini E, Cartier A, Hussack P, Goldsmith CH, Laviolette M, et al. Determining asthma treatment by monitoring sputum cell counts: effect on exacerbations. Eur Respir J. 2006;27(3):483–494. doi:10.1183/09031936.06.00137704.
   PubMed Web of Science ®Google Scholar
• Muneswarao J, Hassali MA, Ibrahim B, Saini B, Ali Hyder Ali I, Verma AK. It is time to change the way we manage mild asthma: an update in GINA 2019. Respir Res. 2019;20(1):183.
   PubMed Web of Science ®Google Scholar
• Boushey HA, Sorkness CA, King TS, Sullivan SD, Fahy JV, Lazarus SC, Chinchilli VM, Craig TJ, Dimango EA, Deykin A, et al. National Heart, Lung, and Blood Institute’s Asthma Clinical Research Network. Daily versus as-needed corticosteroids for mild persistent asthma. N Engl J Med. 2005;352(15):1519–1528. doi:10.1056/NEJMoa042552.
   PubMed Web of Science ®Google Scholar
• Turkish Thoracic Society and Turkish Society of Allergy and Clinical Immunology Guideline on asthma diagnosis and management, 2020 update. Çelik GE Ed., Buluş Tasarım Matbaacılık. Ankara-Turkey. SBN: 978-605-74980-0-7; 2020. https://www.toraks.org.tr/site/community/library/ZNCCbNLFjQgfmgnI [last accessed 24 August 2021].
   Google Scholar
• Aggarwal B, Shantakumar S, Hinds D, Mulgirigama A. Asia-Pacific Survey of Physicians on Asthma and Allergic Rhinitis (ASPAIR): physician beliefs and practices about diagnosis, assessment, and treatment of coexistent disease. J Asthma Allergy. 2018;11:293–307. doi:10.2147/JAA.S180657.
   PubMed Web of Science ®Google Scholar
• Shaw DE, Heaney LG, Thomas M, Beasley R, Gibson PG, Pavord ID. Balancing the needs of the many and the few: where next for adult asthma guidelines? Lancet Respir Med. 2021;9(7):786–794.
   PubMed Web of Science ®Google Scholar
• Cerveri I, Locatelli F, Zoia MC, Corsico A, Accordini S, de Marco R. International variations in asthma treatment compliance: the results of the European Community Respiratory Health Survey (ECRHS). Eur Respir J. 1999;14(2):288–294. doi:10.1034/j.1399-3003.1999.14b09.x.
   PubMed Web of Science ®Google Scholar
• Eakin MN, Rand CS. Improving patient adherence with asthma self-management practices: what works? Ann Allergy Asthma Immunol. 2012;109(2):90–92. doi:10.1016/j.anai.2012.06.009.
   PubMed Web of Science ®Google Scholar
• Mäkelä MJ, Backer V, Hedegaard M, Larsson K. Adherence to inhaled therapies, health outcomes and costs in patients with asthma and COPD. Respir Med. 2013;107(10):1481–1490. doi:10.1016/j.rmed.2013.04.005.
   PubMed Web of Science ®Google Scholar
• Ward C, Pais M, Bish R, Reid D, Feltis B, Johns D, Walters EH. Airway inflammation, basement membrane thickening and bronchial hyperresponsiveness in asthma. Thorax. 2002;57(4):309–316. doi:10.1136/thorax.57.4.309.
   PubMed Web of Science ®Google Scholar
• Gibbons DC, Aggarwal B, Fairburn-Beech J, Hinds D, Fletcher M, Bosnic-Anticevich S, Price D. Treatment patterns among non-active users of maintenance asthma medication in the United Kingdom: a retrospective cohort study in the Clinical Practice Research Datalink. J Asthma. 2021;58(6):793–804. doi:10.1080/02770903.2020.1728767.
   PubMed Web of Science ®Google Scholar
• Dhruve H. Management of asthma: adherence, inhaler technique and self-management. Pract Nursing. 2018;29(10):465–468. doi:10.12968/pnur.2018.29.10.465.
   Google Scholar
• Bousquet J, Winchester C, Papi A, Virchow JC, Haughney J, Costa D, Usmani O, Bjermer L, Price D, Global Allergy and Asthma European Network (GA²LEN). Inhaled corticosteroid/long-acting β2-agonist combination therapy for asthma: attitudes of specialists in Europe. Int Arch Allergy Immunol. 2012;157(3):303–310. doi:10.1159/000329519.
   PubMed Web of Science ®Google Scholar
• Harding G, Leidy NK, Meddis D, Kleinman L, Wagner S, O’Brien CD. Interpreting clinical trial results of patient-perceived onset of effect in asthma: methods and results of a Delphi panel. Curr Med Res Opin. 2009;25(6):1563–1571. doi:10.1185/03007990902914403.
   PubMed Web of Science ®Google Scholar
• Sheikh A, Major P, Holgate ST. Developing consensus on national respiratory research priorities: key findings from the UK Respiratory Research Collaborative’s e-Delphi exercise. Respir Med. 2008;102(8):1089–1092. doi:10.1016/j.rmed.2008.03.006.
   PubMed Web of Science ®Google Scholar