1. Pediatric asthma treatment: What to do when international guideline recommendations do not agree.
- Author
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Larenas Linnemann DES, Fernández Vega M, Luna Pech JA, Villaverde Rosas J, Ortega Martell JA, Del Río Navarro BE, Cano Salas MDC, Romero Lombard J, López Estrada EDC, Rodriguez-González M, Mayorga Butrón JL, Salas Hernández J, Vázquez García JC, Ortiz Aldana I, Vargas Becerra MH, Bedolla Barajas M, Rodríguez Pérez N, Aguilar Aranda A, Jiménez González CA, García Bolaños C, Garrido Galindo C, Mendoza Hernández DA, Mendoza López E, López Pérez G, Wakida Kuzonoki GH, Ruiz Gutiérrez HH, León Molina H, Martínez de la Lanza H, Stone Aguilar H, Gómez Vera J, Olvera Salinas J, Oyoqui Flores JJ, Gálvez Romero JL, Lozano Saenz JS, Salgado Gama JI, Jiménez Chobillon MA, García Avilés MA, Guinto Balanzar MP, Medina Ávalos MA, Camargo Angeles R, García Torrentera R, Toral Freyre S, Montes Narvaez G, Solorio Gómez H, Rosas Peña J, Romero Tapia SJ, Reyes Herrera A, Cuevas Schacht F, Esquer Flores J, Sacre Hazouri JA, Compean Martínez L, Medina Sánchez PJ, Garza Salinas S, Baez Loyola C, Romero Alvarado I, Miguel Reyes JL, Huerta Espinosa LE, Correa Flores MÁ, and Castro Martínez R
- Subjects
- Asthma physiopathology, Child, Child, Preschool, Drug Administration Schedule, Drug Dosage Calculations, Female, Humans, Infant, Male, Mexico, Monitoring, Physiologic, Practice Guidelines as Topic, Anti-Asthmatic Agents therapeutic use, Asthma therapy, Disease Management
- Abstract
Background: There was a need for a solid asthma guideline in Mexico to update and unify asthma management. Because high-quality asthma guidelines exist worldwide, in which the latest evidence on asthma management is summarized, the ADAPTE approach allows for the development of a national asthma guideline based on evidence from already existing guidelines, adapted to national needs., Objective: To fuse evidence from the best asthma guidelines and adapt it to local needs with the ADAPTE approach., Methods: The Appraisal of Guidelines for Research and Evaluation (AGREE) II asthma guidelines were evaluated by a core group to select 3 primary guidelines. For each step of asthma management, clinical questions were formulated and replied according to (1) evidence in the primary guidelines, (2) safety, (3) Cost, and (4) patient preference. The Guidelines Development Group, composed of a broad range of experts from medical specialties, primary care physicians, and methodologists, adjusted the draft questions and replies in several rounds of a Delphi process and 3 face-to-face meetings, taking into account the reality of the situation in Mexico. We present the results of the pediatric asthma treatment part., Results: Selected primary guidelines are from the British Thoracic Society and Scottish Intercollegiate Guidelines Network (BTS/SIGN), Global Initiative for Asthma (GINA), and Spanish Guidelines on the Management of Asthma (GEMA) 2015, with 2016 updates. Recommendations or suggestions were made for asthma treatment in Mexico. In this article, the detailed analysis of the evidence present in the BTS/SIGN, GINA, and GEMA sections on the (non) pharmacologic treatment of pediatric asthma, education, and devices are presented for 2 age groups: children 5 years or younger and children 6 to 11 years old with asthma., Conclusion: For the pediatric treatment and patient education sections, applying the AGREE II and Delphi methods is useful to develop a scientifically sustained document, adjusted to the Mexican situation, as is the Mexican Guideline on Asthma., (Copyright © 2018 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)
- Published
- 2018
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