This project is based on the Delphi method, designed to reach an expert consensus through a multidisciplinary scientific committee addressing the following questions: clinical characteristics, treatment adherence, patient or caregiver administration ability, patient self-care, relationship with the healthcare professional, patient preference, and access to the hospital.
One hundred and thirty-one healthcare professionals (pulmonologists, allergists, nurses, and hospital pharmacists) completed two Delphi consensus questionnaires. Fourteen items were identified as priority characteristics, the first five being: 1. The patient follows the healthcare team\'s indications/recommendations to control their disease, 2. The patient is capable of detecting any deterioration in their disease and of identifying exacerbation triggers, 3. The patient receives biologic therapy and has stable disease with no vital risk, 4. The patient takes responsibility for their self-care, 5. The patient has occupational/educational obligations that prevent them from going to the hospital regularly.
Disease stability and control plus the ability to identify exacerbation triggers are the most important characteristics when opting for at-home administration for a patient with severe uncontrolled asthma on biologic therapy. These recommendations could be applicable in clinical practice.
方法:此项目基于Delphi方法,旨在通过多学科科学委员会解决以下问题达成专家共识:临床特征,治疗依从性,患者或护理人员的管理能力,病人自我护理,与医疗保健专业人员的关系,患者偏好,并进入医院。
结果:一百三十一名医疗保健专业人员(肺科医师,变态反应学家,护士,和医院药剂师)完成了两份德尔菲共识问卷。14个项目被确定为优先特征,前五个是:1。患者遵循医疗团队的适应症/建议来控制他们的疾病,2.患者能够检测到他们疾病的任何恶化,并确定恶化的触发因素,3.患者接受生物治疗,病情稳定,无重大危险,4.病人对他们的自我保健负责,5.患者有职业/教育义务,阻止他们定期去医院。
结论:对于接受生物治疗的重度不受控制的哮喘患者,选择在家中给药时,疾病的稳定性和控制性以及确定恶化触发因素的能力是最重要的特征。这些建议可能适用于临床实践。