Expert Consensus on SABA Use for Asthma Clinical Decision-Making: A Delphi Approach.

IF 5.4 2区医学 Q1 ALLERGY Current Allergy and Asthma Reports Pub Date : 2023-11-01 Epub Date: 2023-11-22 DOI:10.1007/s11882-023-01111-z

Njira Lugogo, Maeve O'Connor, Maureen George, Rajan Merchant, Greg Bensch, Jay Portnoy, John Oppenheimer, Mario Castro

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Abstract

Purpose of review: A modified Delphi process was undertaken to provide a US expert-led consensus to guide clinical action on short-acting beta₂-agonist (SABA) use. This comprised an online survey (Phase 1), forum discussion and statement development (Phase 2), and statement adjudication (Phase 3).

Recent findings: In Phase 1 (n = 100 clinicians), 12% routinely provided patients with ≥4 SABA prescriptions/year, 73% solicited SABA use frequency at every patient visit, and 21% did not consult asthma guidelines/expert reports. Phase 3 experts (n = 8) reached consensus (median Likert score, interquartile range) that use of ≥3 SABA canisters/year is associated with increased risk of exacerbation and asthma-related death (5, 4.75-5); SABA use history should be solicited at every patient visit (5, 4.75-5); usage patterns over time, not absolute thresholds, should guide response to SABA overuse (5, 4.5-5). Future asthma guidelines should include clear recommendations regarding SABA usage, using expert-led thresholds for action.

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专家共识SABA用于哮喘临床决策:德尔菲法。

综述目的:采用一种改进的德尔菲过程，以提供美国专家主导的共识，指导短效β -受体激动剂(SABA)的临床使用。该研究包括在线调查(第一阶段)、论坛讨论和陈述制定(第二阶段)和陈述裁决(第三阶段)。最近的发现:在第一阶段(n = 100名临床医生)，12%的临床医生每年常规为患者提供≥4张SABA处方，73%的患者在每次就诊时征求SABA的使用频率，21%的患者没有参考哮喘指南/专家报告。3期专家(n = 8)达成共识(Likert评分中位数，四分位数范围)，即每年使用≥3个SABA罐与加重和哮喘相关死亡的风险增加相关(5,4.75 -5);患者每次就诊时应询问SABA使用历史(5,4.75 -5);随着时间推移的使用模式，而不是绝对的阈值，应该指导对SABA过度使用的反应(5,4.5 -5)。未来的哮喘指南应包括关于SABA使用的明确建议，使用专家主导的行动阈值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Allergy and Asthma Reports 医学-过敏

CiteScore

11.20

自引率

1.80%

发文量

审稿时长

6-12 weeks

期刊介绍： The aim of Current Allergy and Asthma Reports is to systematically provide the views of highly selected experts on current advances in the fields of allergy and asthma and highlight the most important papers recently published. All reviews are intended to facilitate the understanding of new advances in science for better diagnosis, treatment, and prevention of allergy and asthma. We accomplish this aim by appointing international experts in major subject areas across the discipline to review select topics emphasizing recent developments and highlighting important new papers and emerging concepts. We also provide commentaries from well-known figures in the field, and an Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. Over a one- to two-year period, readers are updated on all the major advances in allergy and asthma.

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