Spanish consensus on the characteristics of severe asthmatic patients under biological treatment suitable for at home administration

Abstract

Background: Biologics have demonstrated improvement in control of symptoms and decrease exacerbations in severe uncontrolled asthmatic patients.

Objective: To identify the characteristics of patients with severe asthma who would be benefit from a biological treatment administered at home.

Method: Consensus through a modified Delphi survey performed by healthcare professionals and developed by a multidisciplinary scientific committee, included five topics: clinical characteristics, therapeutic adherence and ability of the patient or caregiver for administration, self-care of the patient, relationship with the healthcare professional and patient preference and access to the hospital.

Results: Pulmonologists (32.8%); allergists (26.7%); nursing (22.2%) and hospital pharmacists (18.3%) (n=131) answered Delphi consensus. Fourteen items were identified as priority characteristics, the first five ordered from highest to lowest degree of agreement were: 1. Patient follows health team’s indications on managing the disease, 2. Patient able to detect any deterioration in the disease and to identify triggers for an exacerbation, 3. Stable patient undergoing treatment with a biological drug, not life-threatening, 4. Patient who is responsible for the care of the illness, 5. Patient who has work/school duties that prevent from visiting the hospital regularly.

Conclusion: Patient adherence, stability and control of severe uncontrolled asthma and ability of patient to identify the triggers of an exacerbation are the most important features when selecting home administration for a severe asthmatic patient undergoing biological treatment.