Table 3 Overview of results Delphi round 3
Category | Name item | Rank |
|---|---|---|
Background | Explanation what is difficult-to-manage asthma | 1 |
Identification of patients with difficult-to-manage asthma | 2 | |
What is the difference between difficult-to-manage asthma and severe asthma | 3 | |
Clear guidelines for referrals between primary and hospital care | 4 | |
Further insight into the potential consequences of a diagnosis of severe asthma (such as the use of biologicals, revalidation-therapy, high-altitude treatment.) | 5 | |
Diagnosis | Has asthma been diagnosed according to the guidelines | 1 |
Differential diagnosis of asthma and which potential concurrent diagnoses require further investigation | 2 | |
The role of comorbidity in asthma | 3 | |
How to assess different phenotypes of asthma in a patient | 3 | |
Role of the ACQ | 3 | |
Role of different phenotypes of asthma | 6 | |
Which other tests should/could be performed other than symptoms and spirometry, to diagnose asthma | 7 | |
Monitoring | Content of monitoring in the individual patient | 1 |
Determining current control | 2 | |
Frequency of monitoring for the individual patient | 3 | |
Exacerbation | An asthma action plan for every difficult-to-manage asthma patient | 1 |
Identification of patients with an increased risk | 2 | |
Definition of (severe) asthma exacerbation | 3 | |
Recognition of causing agents of exacerbations | 4 | |
Types of medication | Denominate central role-inhaled corticosteroids | 1 |
Pharmacotherapy for specific subgroups: does comorbidity determine medication choices | 2 | |
Name common side-effects different types of medication | 3 | |
Use of medication | Role of inhalation instruction | 1 |
Assessment of adherence | 2 | |
Role of device type | 3 | |
Smoking | Effect of smoking on asthma | 1 |
Role of passive smoking | 2 | |
Other irritants | Insight into allergens | 1 |
Insight into nonspecific irritants | 2 | |
Insight into occupational irritants | 3 | |
Insight into hobby-related irritants | 4 | |
Lifestyle | Identification of obstacles for adherence (social, financial, societal) | 1 |
Attention for physical activity | 2 | |
Role of weight | 3 | |
Identification of patients suitable for pulmonary rehabilitation | 4 | |
Recognition of stress-inducing factors | 5 | |
Education and self-management | Self-management for all people with (difficult-to-manage) asthma | 1 |
Patient perceptions on benefits and necessity medications | 2 | |
Education on asthma | 3 | |
Identification of patients suited to different types of self-management: paper, online, real-life | 4 | |
How to make patients aware of asthma worsening events/behaviour | 5 | |
Patient Profile | Insight into the patients' personal environment | 1 |
Knowledge about the relation between symptoms and work | 2 | |
Individual care plan | Necessity of an individual care plan for all patients with (difficult-to-manage) asthma | 1 |
Recognition and acceptance of personal limitations | 2 | |
Determining personal goals of treatment. | 2 | |
Estimation of desire and potential for behavioural changes | 4 |
