[Consensus-based approach for severe paediatric asthma in routine clinical practice]

Area of Science:

• Pediatric Pulmonology
• Allergy and Immunology
• Clinical Practice Guidelines

Background:

• Accurate identification of severe paediatric asthma is crucial for effective disease management.
• Existing guidelines for severe asthma definition and control recommendations lack uniformity.
• Variability in criteria complicates optimal care for children with severe asthma.

Purpose of the Study:

• To establish expert consensus on the definition and management of severe paediatric asthma.
• To develop practice guidelines for severe paediatric asthma based on expert opinion.
• To address the need for standardized criteria in managing this condition.

Main Methods:

• An online survey utilizing a modified Delphi technique was employed.
• Expert opinions from eleven paediatric chest disease physicians and allergy specialists were gathered.
• Analysis of survey results informed the development of consensus-based practice guidelines.

Main Results:

• Consensus was achieved on 76.92% of the surveyed questions (50 out of 65).
• Key criteria for severe paediatric asthma include frequent oral steroid use, high-dose inhaled corticosteroids, lack of response to treatment, or life-threatening/quality-of-life impairing disease.
• Recommendations include using paediatric-specific monitoring questionnaires (e.g., CAN, ACT) and considering omalizumab before oral corticosteroids.

Conclusions:

• The study provides consensus recommendations for the management of severe paediatric asthma.
• These guidelines offer a standardized approach to identifying and treating children with severe asthma.
• The recommendations aim to improve clinical decision-making and patient outcomes.