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Factores clave para la implementación de cambios de régimen de inhaladores en enfermedades respiratorias: consenso
Omar S Usmani1, Nicolas Roche2, Job F M van Boven3
1National Heart and Lung Institute, Imperial College London, London, UK.
NPJ primary care respiratory medicine
|February 23, 2026
Resumen
El consenso de expertos destaca la priorización de la necesidad clínica y la participación del paciente para los interruptores de inhalador en el asma y la EPOC. El cambio seguro requiere consulta, consentimiento y educación, no factores de costo o ambientales.
Área de la Ciencia:
- Medicina de las vías respiratorias.
- Política de salud Política de salud
- La seguridad del paciente.
Sus antecedentes:
- El cambio de inhalador es común en el manejo del asma y la EPOC.
- Las directrices actuales carecen de estrategias integrales para transiciones seguras y efectivas de los inhaladores.
- Se necesita un consenso de expertos para estandarizar los protocolos de conmutación de inhaladores.
Objetivo del estudio:
- Establecer un consenso internacional de expertos sobre las prácticas óptimas de cambio de inhalador.
- Para definir las circunstancias apropiadas, las funciones de las partes interesadas y los pasos esenciales para los interruptores de inhalador.
- Informar a los médicos y tomadores de decisiones sobre las transiciones seguras y efectivas al inhalador.
Principales métodos:
- Técnica de grupo nominal internacional con ocho expertos clínicos, pagadores y pacientes.
- Generación y calificación de ideas sobre los conductores y circunstancias del cambio de inhalador.
- Aplicación del marco de la unidad de toma de decisiones para el mapeo de las partes interesadas.
Principales resultados:
- Los controladores clínicos y centrados en el paciente (por ejemplo, control de enfermedades, técnica) son primordiales para los interruptores de inhaladores.
- La seguridad del paciente es la principal preocupación, lo que requiere consulta, consentimiento, educación y seguimiento.
- Los factores de costo y medio ambiente se consideraron los factores menos importantes para el cambio de inhalador.
Conclusiones:
- Los interruptores de inhaladores deben priorizar la necesidad clínica y la participación del paciente sobre el costo o la sostenibilidad.
- Los responsables de la formulación de políticas deben considerar el tiempo y la complejidad involucrados en la implementación a gran escala del interruptor de inhalador.
- El desarrollo de protocolos estandarizados asegura transiciones seguras y efectivas del inhalador para pacientes respiratorios.
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