ERS/EAACI statement on adherence to international adult asthma guidelines.

Autor:	Mathioudakis AG; Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, UK a.mathioudakis@nhs.net.; North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.; These authors were Task Force Co-chairs and are equal authors., Tsilochristou O; Dept of Allergy, Guy's and St Thomas' Foundation Trust, London, UK.; Peter Gorer Dept of Immunobiology, King's College London, London, UK.; These authors were Task Force Co-chairs and are equal authors., Adcock IM; National Heart and Lung Institute, Imperial College London and the NIHR Imperial Biomedical Research Centre, London, UK., Bikov A; Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, UK.; North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK., Bjermer L; Respiratory Medicine and Allergology, Dept of Clinical Sciences, Lund University, Lund, Sweden., Clini E; Dept of Medical Specialities, University Hospital of Modena, University of Modena-Reggio Emilia, Modena, Italy., Flood B; European Federation of Allergy and Airways Diseases Patients Association (EFA), Dublin, Ireland., Herth F; Dept of Pneumology and Critical Care Medicine, Thoraxklinik and Translational Lung Research Center Heidelberg, University of Heidelberg, Heidelberg, Germany., Horvath I; National Koranyi Institute for Pulmonology, Budapest, Hungary.; Institute of Public Health, Semmelweis University, Budapest, Hungary., Kalayci O; Hacettepe University School of Medicine, Ankara, Turkey., Papadopoulos NG; Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, UK.; Allergy Dept, Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece., Ryan D; Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, UK., Sanchez Garcia S; Allergy Dept, University Children's Hospital Niño Jesus, Madrid, Spain., Correia-de-Sousa J; Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.; ICVS/3B's - PT Government Associate Laboratory, Guimarães, Portugal., Tonia T; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland., Pinnock H; Asthma UK Centre for Applied Research, Usher Institute, University of Edinburgh, Edinburgh, UK., Agache I; Allergy & Clinical Immunology, Transylvania University, Brasov, Romania.; These authors were Task Force Co-chairs and are equal authors., Janson C; Dept of Medical Science, Respiratory, Allergy and Sleep Research, Uppsala University and University Hospital, Uppsala, Sweden.; These authors were Task Force Co-chairs and are equal authors.
Jazyk:	angličtina
Zdroj:	European respiratory review : an official journal of the European Respiratory Society [Eur Respir Rev] 2021 Sep 15; Vol. 30 (161). Date of Electronic Publication: 2021 Sep 15 (Print Publication: 2021).
DOI:	10.1183/16000617.0132-2021
Abstrakt:	Guidelines aim to standardise and optimise asthma diagnosis and management. Nevertheless, adherence to guidelines is suboptimal and may vary across different healthcare professional (HCP) groups.Further to these concerns, this European Respiratory Society (ERS)/European Academy of Allergy and Clinical Immunology (EAACI) statement aims to: 1) evaluate the understanding of and adherence to international asthma guidelines by HCPs of different specialties via an international online survey; and 2) assess strategies focused at improving implementation of guideline-recommended interventions, and compare process and clinical outcomes in patients managed by HCPs of different specialties via systematic reviews.The online survey identified discrepancies between HCPs of different specialties which may be due to poor dissemination or lack of knowledge of the guidelines but also a reflection of the adaptations made in different clinical settings, based on available resources. The systematic reviews demonstrated that multifaceted quality improvement initiatives addressing multiple challenges to guidelines adherence are most effective in improving guidelines adherence. Differences in outcomes between patients managed by generalists or specialists should be further evaluated.Guidelines need to consider the heterogeneity of real-life settings for asthma management and tailor their recommendations accordingly. Continuous, multifaceted quality improvement processes are required to optimise and maintain guidelines adherence. Validated referral pathways for uncontrolled asthma or uncertain diagnosis are needed. Competing Interests: Conflict of interest: A.G. Mathioudakis reports grants from Boehringer Ingelheim, outside the submitted work. Conflict of interest: O. Tsilochristou has nothing to disclose. Conflict of interest: I.M. Adcock has nothing to disclose. Conflict of interest: A. Bikov has nothing to disclose. Conflict of interest: L. Bjermer has nothing to disclose. Conflict of interest: E. Clini has nothing to disclose. Conflict of interest: B. Flood has nothing to disclose. Conflict of interest: F. Herth received personal fees for advisory board activities and lecture fees from Pulmonx, BTG, Olympus and Uptake, outside the submitted work. Conflict of interest: I. Horvath reports personal fees from AstraZeneca, Chiesi, Berlin-Chemie, Boehringer-Ingelheim, GSK, Teva, CSL, Novartis and Roche, outside the submitted work. Conflict of interest: O. Kalayci has nothing to disclose. Conflict of interest: N.G. Papadopoulos reports personal fees from Novartis, Nutricia, HAL, MENARINI/FAES FARMA, SANOFI, MYLAN/MEDA, BIOMAY, AstraZeneca, GSK, MSD, ASIT BIOTECH and Boehringer Ingelheim, and grants from Gerolymatos International SA and Capricare, outside the submitted work. Conflict of interest: D. Ryan reports personal fees from Boehringer Ingelheim, AstraZeneca, Regeneron, Trudell, GSK and Novartis, and non-financial support from Chiesi, outside the submitted work. Conflict of interest: S. Sanchez Garcia has nothing to disclose. Conflict of interest: J. Correia-de-Sousa reports other funding from Boheringer Ingelheim and Novartis, grants, personal fees and other from GSK and AstraZeneca, personal fees and other from Bial, non-financial support from Mundipharma, and personal fees from Sanofi, outside the submitted work. Conflict of interest: T Tonia reports acting as ERS Methodologist. Conflict of interest: H. Pinnock reports personal fees from lecture fees from Boehringer Ingelheim, outside the submitted work. Conflict of interest: I. Agache is an Associate Editor for Allergy and CTA. Conflict of interest: C. Janson reports personal fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, and Novartis, outside the submitted work. (Copyright ©The authors 2021.)
Databáze:	MEDLINE
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