%0 Journal Article
%T Personalising care of adults with asthma from Asia: a modified e-Dephi consensus study to inform management tailored to attitude and control profiles
%A Aileen David-Wang
%A Alison Chisholm
%A Camilo Roa
%A David B Price
%A Dermot Ryan
%A Gary Wong
%A Hilary Pinnock
%A Nina Castillo-Carandang
%A Sang-Heon Cho
%A Tan Tze Lee
%A Thys van der Molen
%A Yee Vern Yong
%J Archive of "NPJ Primary Care Respiratory Medicine".
%D 2017
%R 10.1038/npjpcrm.2016.89
%X REALISE Asia¡ªan online questionnaire-based study of Asian asthma patients¡ªidentified five patient clusters defined in terms of their control status and attitude towards their asthma (categorised as: ¡®Well-adjusted and at least partly controlled¡¯; ¡®In denial about symptoms¡¯; ¡®Tolerating with poor control¡¯; ¡®Adrift and poorly controlled¡¯; ¡®Worried with multiple symptoms¡¯). We developed consensus recommendations for tailoring management of these attitudinal¨Ccontrol clusters. An expert panel undertook a three-round electronic Delphi (e-Delphi): Round 1: panellists received descriptions of the attitudinal¨Ccontrol clusters and provided free text recommendations for their assessment and management. Round 2: panellists prioritised Round 1 recommendations and met (or joined a teleconference) to consolidate the recommendations. Round 3: panellists voted and prioritised the remaining recommendations. Consensus was defined as Round 3 recommendations endorsed by >50% of panellists. Highest priority recommendations were those receiving the highest score. The multidisciplinary panellists (9 clinicians, 1 pharmacist and 1 health social scientist; 7 from Asia) identified consensus recommendations for all clusters. Recommended pharmacological (e.g., step-up/down; self-management; simplified regimen) and non-pharmacological approaches (e.g., trigger management, education, social support; inhaler technique) varied substantially according to each cluster¡¯s attitude to asthma and associated psychosocial drivers of behaviour. The attitudinal¨Ccontrol clusters defined by REALISE Asia resonated with the international panel. Consensus was reached on appropriate tailored management approaches for all clusters. Summarised and incorporated into a structured management pathway, these recommendations could facilitate personalised care. Generalisability of these patient clusters should be assessed in other socio-economic, cultural and literacy groups and nationalities in Asia
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5215112/