학술논문
Pediatric asthma treatment: What to do when international guideline recommendations do not agree.
Document Type
Academic Journal
Author
Larenas Linnemann DES; Investigational Unit, Hospital Médica Sur, Mexico City, Mexico. Electronic address: marlar1@prodigy.net.mx.; Fernández Vega M; Dean's Office, Instituto Nacional de Enfermedades Respiratorias 'Ismael Cosio Villegas', Mexico City, Mexico; Pregraduate Pulmonology Department, Medical Faculty, Universidad Nacional Autónoma de México, Mexico City, Mexico.; Luna Pech JA; Department of Philosophical, Methodological, and Instrumental Disciplines, University Center of Science in Health, Universidad de Guadalajara, Guadalajara, Mexico.; Villaverde Rosas J; A2DAHT Iberoamerican Agency for Development & Assessment of Health Technologies, Mexico City, Mexico.; Ortega Martell JA; Department of Pre and Postgraduate Medicine, Universidad Autónoma de Hidalgo, Pachuca, Mexico.; Del Río Navarro BE; Department of Allergy and Clinical Immunology, Pediatric Hospital of Mexico 'Federico Gómez', Mexico City, Mexico; Postgraduate Department, Medical Faculty, Universidad Nacional Autónoma de México, Mexico City, Mexico.; Cano Salas MDC; Department of Postgraduate Medicine of the Instituto Nacional de Enfermedades Respiratorias 'Ismael Cosio Villegas', Mexico City, Mexico.; Romero Lombard J; ISSSTE Hospital Saltillo, Nuevo León, Mexico.; López Estrada EDC; Asthma Clinic, Instituto Nacional de Enfermedades Respiratorias 'Ismael Cosio Villegas', Mexico City, Mexico.; Rodriguez-González M; Private practice, Mexico City, Mexico.; Mayorga Butrón JL; A2DAHT Iberoamerican Agency for Development & Assessment of Health Technologies, Mexico City, Mexico; Postgraduate Department, Medical Faculty, Universidad Nacional Autónoma de México, Mexico City, Mexico; ENT Department, Instituto Nacional de Pediatría, Mexico City, Mexico.; Salas Hernández J; General Management, Instituto Nacional de Enfermedades Respiratorias 'Ismael Cosio Villegas', Mexico City, Mexico.; Vázquez García JC; Dean's Office, Instituto Nacional de Enfermedades Respiratorias 'Ismael Cosio Villegas', Mexico City, Mexico.; Ortiz Aldana I; Secretary of Health of the State of Guanajuato, Guanajuato, Mexico.; Vargas Becerra MH; Instituto Nacional de Enfermedades Respiratorias 'Ismael Cosio Villegas', Mexico City, Mexico; Unit of Medical Investigations in Respiratory Medicine, Instituto Mexicano del Seguro Social, Mexico City, Mexico.; Bedolla Barajas M; Civil Hospital of Guadalajara 'Dr. Juan I. Menchaca', Guadalajara, Mexico.; Rodríguez Pérez N; Institute of Science and Superior Studies of Tamaulipas, Universidad Autónoma de Tamaulipas, Matamoros, Mexico.; Aguilar Aranda A; Medical Unit of High-Level Specialization, Hospital de Pediatría Centro Médico de Occidente, Mexico City, Mexico.; Jiménez González CA; Medical Faculty of the Universidad Autónoma San Luis Potosí, San Luis Potosí, Mexico.; García Bolaños C; General Hospital 'Doctor Gaudencio González Garza', Centro Médico Nacional La Raza, Mexico City, Mexico.; Garrido Galindo C; Instituto Nacional de Enfermedades Respiratorias 'Ismael Cosio Villegas', Mexico City, Mexico.; Mendoza Hernández DA; Allergy Department, Instituto Nacional de Pediatría, Mexico City, Mexico.; Mendoza López E; Sistema Tec Salud, Hospital San José, Monterrey, Mexico.; López Pérez G; Allergy Department, Instituto Nacional de Pediatría, Mexico City, Mexico.; Wakida Kuzonoki GH; Hospital Central Sur de Alta Especialidad, Petróleos, Mexico.; Ruiz Gutiérrez HH; Servicio de Neumología Pediátrica, Centro Médico Nacional de Occidente, IMSS, Guadalajara, Jalisco.; León Molina H; Private practice, Mexico City, Mexico.; Martínez de la Lanza H; Private practice, Oaxaca, Oaxaca.; Stone Aguilar H; Hospital San José de Hermosillo, Hermosillo, Mexico.; Gómez Vera J; Allergy Department, Hospital Regional Lic. Adolfo López Mateos, ISSSTE, Mexico City, Mexico.; Olvera Salinas J; Servicio de Neumología Pediátrica, Centro Médico Nacional de Occidente, IMSS, Guadalajara, Jalisco.; Oyoqui Flores JJ; Private practice, Uruapan, Michoacan, Mexico.; Gálvez Romero JL; Instituto de Seguridad y de Servicios Sociales de los Trabajadores del Estado (ISSSTE), Regional, Puebla, Mexico.; Lozano Saenz JS; Private practice, Jalapa, Veracruz, Mexico.; Salgado Gama JI; Clínica del Niño y del Adolescente de Coatzacoalcos, Veracruz, Mexico.; Jiménez Chobillon MA; Instituto Nacional de Enfermedades Respiratorias 'Ismael Cosio Villegas', Mexico City, Mexico.; García Avilés MA; Secretary of Health, National Center for Preventive Programs for Disease Control, Mexico City, Mexico.; Guinto Balanzar MP; Private practice, Mexico City, Mexico.; Medina Ávalos MA; Instituto de Seguridad y de Servicios Sociales de los Trabajadores del Estado (ISSSTE) of Veracruz, Veracruz, Mexico.; Camargo Angeles R; Secretary of Health, National Center for Preventive Programs for Disease Control, Mexico City, Mexico.; García Torrentera R; Instituto Nacional de Enfermedades Respiratorias 'Ismael Cosio Villegas', Mexico City, Mexico.; Toral Freyre S; Instituto Nacional de Enfermedades Respiratorias 'Ismael Cosio Villegas', Mexico City, Mexico.; Montes Narvaez G; Private practice, Mexico City, Mexico.; Solorio Gómez H; Private practice, Puebla, Mexico.; Rosas Peña J; Private practice, Guadalajara, Mexico.; Romero Tapia SJ; Unit of Education and Investigation, Hospital de Alta Especialidad del Niño 'Dr. Rodolfo Nieto Padrón', Villahermosa, Tabasco, Mexico; División Académica, Universidad Juárez Autónoma, Tabasco, Mexico.; Reyes Herrera A; National College of Nursing, Mexico City, Mexico.; Cuevas Schacht F; Departament of Pulmonology and Thoracic Surgery, Instituto Nacional de Pediatría, Mexico City, Mexico.; Esquer Flores J; Hospital del ISSSSTE, 'Fray Junipero Serra', Tijuana, Mexico.; Sacre Hazouri JA; Private practice, Jalapa, Veracruz, Mexico.; Compean Martínez L; Servicio de Otorrinolaringología del Centenario Hospital Hidalgo de Aguascalientes, Aguascalientes, Mexico.; Medina Sánchez PJ; Hospital Regional ISSSSTE, León, Guanajuato.; Garza Salinas S; Hospital San José del Tecnológico de Monterrey, Monterrey, Mexico.; Baez Loyola C; Private practice, Mexico City, Mexico.; Romero Alvarado I; Emergency Department, Hospital Infantil de México 'Federico Gómez', Mexico City, Mexico.; Miguel Reyes JL; Instituto Nacional de Enfermedades Respiratorias 'Ismael Cosio Villegas', Mexico City, Mexico.; Huerta Espinosa LE; Pediatric Hospital of Legaria of the Secretary of Health, Mexico City, Mexico.; Correa Flores MÁ; Centro Médico Nacional 'La Raza', Mexico City, Mexico.; Castro Martínez R; Private practice, San Luis Potosí, Mexico.
Source
Publisher: American College of Allergy, Asthma, and Immunology Country of Publication: United States NLM ID: 9503580 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1534-4436 (Electronic) Linking ISSN: 10811206 NLM ISO Abbreviation: Ann Allergy Asthma Immunol Subsets: MEDLINE
Subject
Language
English
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.)
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.)