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Consensus on mild asthma management: results of a modified Delphi study
Christian Domingo1, Gabriel Garcia2, Bilun Gemicioglu3
1Pneumology Service, Corporació Parc Taulí, Sabadell, Spain.
Summary
Regular inhaled corticosteroids (ICS) are recommended for mild asthma management over as-needed ICS-formoterol. Adherence education is crucial for effective asthma control and reducing exacerbations.
Area of Science:
- Pulmonology
- Respiratory Medicine
- Asthma Management
Background:
- Mild asthma management strategies are evolving.
- Understanding the optimal role of inhaled corticosteroids (ICS) is critical.
- Comparing regular ICS versus as-needed ICS-formoterol requires expert consensus.
Purpose of the Study:
- To establish expert consensus on managing mild asthma.
- To compare regular ICS with as-needed ICS-formoterol.
- To identify key treatment goals and adherence strategies.
Main Methods:
- A modified Delphi procedure was employed.
- 16 respiratory experts participated in surveys and a workshop.
- Consensus was defined as 70% agreement.
Main Results:
- 85% agreement: Regular daily ICS is preferred over as-needed ICS-formoterol for mild persistent asthma due to better symptom control and long-term data.
- 100% agreement: Ongoing education on adherence is vital to combat noncompliance in mild asthma patients.
- 92% agreement: Asthma control and 85% agreement: Exacerbation risk reduction are primary treatment aims.
- No consensus on GINA vs. national guideline influence.
Conclusions:
- Encouraging patient adherence and targeting both asthma control and exacerbation risk reduction are essential.
- Robust clinical evidence supports proactive regular ICS controller therapy plus as-needed short-acting beta-agonists for mild asthma.
- Expert consensus favors regular ICS for mild asthma management.
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