Table 2 Overview of items selected in round 1 and the results of the Delphi procedure
Name item | Percentage of participants that scored ⩾5 | Mean score | Selected a |
|---|---|---|---|
Diagnosis and monitoring | |||
Explanation what is difficult-to-manage asthma | 98% | 6.3 | Yes |
Identification of patients with difficult-to-manage asthma | 93% | 6.1 | Yes |
What is the difference between difficult-to-manage asthma and severe asthma | 90% | 5.9 | Yes |
Further insight into the potential consequences of a diagnosis of severe asthma (such as the use of biologicals, revalidation-therapy, high-altitude treatment.) | 88% | 5.7 | Yes |
Has asthma been diagnosed according to the current guidelines | 81% | 5.8 | Yes |
The role of comorbid diseases in asthma | 76% | 5.4 | No |
Differential diagnosis of asthma and which potential concurrent diagnoses require further investigation/management | 86% | 5.6 | Yes |
Which other tests should/could be performed other than symptoms and spirometry, to diagnose asthma | 86% | 5.3 | Yes |
Role of blood eosinophils | 62% | 4.9 | No |
Role of NT-BNP | 36% | 4.1 | No |
Role of histamine-provocation | 71% | 5.1 | No |
Role of FeNO | 45% | 4.5 | No |
Role of pulmonary imagining | 40% | 4.1 | No |
Role of the ACQ | 83% | 5.6 | Yes |
Role of the AQLQ | 48% | 4.6 | No |
Role of the RIC-MON 10 | 26% | 3.7 | No |
Role of spirometry | 71% | 5.3 | No |
Role of different phenotypes of asthma | 83% | 5.7 | Yes |
How to assess different phenotypes of asthma in a patient | 86% | 5.6 | Yes |
Identification of patients with an increased risk of asthma exacerbations | 90% | 5.8 | Yes |
Frequency of monitoring for the individual patient | 83% | 5.4 | Yes |
Clear guidelines for referrals between primary and hospital care | 86% | 5.8 | Yes |
Determining current control | 88% | 5.8 | Yes |
Content of monitoring in the individual patient | 90% | 5.8 | Yes |
Additional use of spirometry in patients with no symptoms and persistent obstruction | 79% | 5.3 | No |
Additional use of spirometry in patients with a lot of symptoms and a normal lung function | 79% | 5.3 | No |
Role of peak flow in daily monitoring | 40% | 4.0 | No |
Identification of patients suitable for pulmonary rehabilitation | 83% | 5.5 | Yes |
Determining general goals of treatment | 74% | 5.1 | No |
Determining personal goals of treatment. | 98% | 6.0 | Yes |
Medication(-related) therapy | |||
Denominate central role-inhaled corticosteroids | 90% | 5.9 | Yes |
Name common side-effects of different types of medication | 93% | 5.5 | Yes |
Pharmacotherapy for specific subgroups: does comorbidity determine medication choices | 86% | 5.4 | Yes |
Identification of suitable patients for LTRA | 76% | 4.9 | No |
Role of inhalation instruction | 90% | 6.2 | Yes |
Role of device type | 88% | 5.8 | Yes |
Inventarisation of adherence | 93% | 6.0 | Yes |
Role of particle size | 62% | 4.9 | No |
Patient perceptions on benefits and necessity of medication | 93% | 6.0 | Yes |
Non-pharmacological management | |||
Follow-up of comorbidity | 74% | 5.0 | No |
An asthma action plan for every asthma patient | 71% | 5.1 | No |
An asthma action plan for every difficult-to-manage asthma patient | 98% | 6.2 | Yes |
Recognition of causing agents of exacerbations | 86% | 5.7 | Yes |
Effect of smoking on asthma | 90% | 6.0 | Yes |
Role of passive smoking | 86% | 5.6 | Yes |
Other types of drugs | 69% | 5.1 | No |
Insight into aspecific irritants | 95% | 6.0 | Yes |
Insight into allergens | 97% | 6.0 | Yes |
Insight into occupational irritants | 93% | 5.8 | Yes |
Insight into hobby-related irritants | 83% | 5.5 | Yes |
Attention for physical activity | 90% | 5.8 | Yes |
Role of weight | 90% | 5.8 | Yes |
Identification of obstacles for adherence (social, financial, societal) | 88% | 5.7 | Yes |
Recognition of stress-inducing factors | 81% | 5.5 | Yes |
Self-management for all people with (difficult to manage) asthma | 95% | 6.0 | Yes |
Identification of patients suited to different types of self-management: paper, online, real-life | 83% | 5.5 | Yes |
Role of eHealth | 64% | 5.0 | No |
How to make patients aware of asthma worsening events/behaviour | 93% | 5.7 | Yes |
Education on asthma | 86% | 5.6 | Yes |
Insight into the patients personal environment | 90% | 5.5 | Yes |
Getting a patients’ environment involved in treatment | 79% | 5.3 | No |
Knowledge about the relation between symptoms and work | 88% | 5.6 | Yes |
Necessity of an individual care plan for all patients with (difficult to manage) asthma | 83% | 5.7 | Yes |
Recognition and acceptance of personal limitations | 88% | 5.7 | Yes |
Estimation of desire and potential for behavioural changes | 88% | 5.6 | Yes |
