Humanitas University, Personalized Medicine Asthma & Allergy Clinic-Humanitas Research Hospital IRCCS, Milan, Italy.
Dipartimento di Medicina e Chirurgia, Università degli Studi dell'Insubria, Varese, Italy; Dipartimento di Medicina e Riabilitazione Cardio-Respiratoria, Istituti Clinici Scientici Maugeri, IRCCS Tradate, Varese, Italy.
Respir Med. 2022 Oct;202:106942. doi: 10.1016/j.rmed.2022.106942. Epub 2022 Aug 4.
Definitions and measures of asthma control used in clinical trials and in clinical practice vary considerably. There is also misalignment between patients and healthcare professionals (HCPs) in terms of understanding and managing asthma control. This study aimed to progress towards a consensus definition of asthma control, and evaluate disparities between HCP and patient perspectives.
A two-stage Delphi questionnaire involving asthma specialists sought to identify areas of consensus on aspects of asthma control in clinical practice. Results were compared with those of a structured literature review to assess if existing guidance and measures of asthma control used in studies correlated with practice. Eighty-two panelists took part in the Delphi questionnaire. The structured literature review included 185 manuscripts and 31 abstracts.
Panelists agreed that there was no standard definition of asthma control, confirmed by a total of 19 different composite consensus/guideline definitions and/or validated measures of control being identified across the Delphi study and literature review. Panelists agreed on the positive associations of well-controlled asthma with patient outcomes, but not on the components or thresholds of a working definition of control.
A universally accepted definition and measure of asthma control that is utilized and understood by patients, HCPs, and researchers is required.
临床试验和临床实践中使用的哮喘控制定义和衡量标准差异很大。患者和医疗保健专业人员（HCP）在理解和管理哮喘控制方面也存在错位。本研究旨在推进哮喘控制的共识定义，并评估 HCP 和患者观点之间的差异。
一项涉及哮喘专家的两阶段德尔菲问卷调查旨在确定临床实践中哮喘控制方面的共识领域。结果与结构化文献综述进行比较，以评估现有指导和研究中使用的哮喘控制衡量标准是否与实践相关。82 名小组成员参加了德尔菲问卷调查。结构化文献综述包括 185 篇手稿和 31 篇摘要。
小组成员一致认为目前尚无哮喘控制的标准定义，这一点得到了德尔菲研究和文献综述中总共 19 种不同的综合共识/指南定义和/或经过验证的控制衡量标准的证实。小组成员一致认为控制良好的哮喘与患者结局之间存在积极关联，但对控制的工作定义的组成部分或阈值存在分歧。
需要一种被患者、HCP 和研究人员使用和理解的通用接受的哮喘控制定义和衡量标准。
