Definition of Mild Asthma in Argentina: Expert Consensus by Delphi Method
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Abstract
Introduction: Mild asthma affects 50–75% of patients with asthma and can progress to severe exacerbations. The literature offers multiple definitions, with discrepancies based in the definition of its control and treatment required to achieve it. The objective of our work was to create a practical definition of mild asthma in adults through expert consensus, in order to apply it at different levels of care.
Methods: A literature review was conducted, followed by the modified Delphi method, which included three rounds of consultations and a plenary meeting. Nineteen experts from various geographic regions of the country participated.
Results: By consensus, mild asthma was characterized by symptomatic control achieved with low doses of inhaled corticosteroids (ICS), ICS/salbutamol, or ICS/formoterol as needed. This control is defined as daytime symptoms occurring ≤2 times per week, nighttime symptoms occurring ≤1 time per month, no functional limitations or exacerbations in the past year, and normal spirometry. Patients with a history of near-fatal asthma, hospitalizations, active smoking, significant comorbidities, or pregnancy were excluded. SABA monotherapy was discouraged.
Conclusion: A retrospective, operational definition of mild asthma is proposed, based on the treatment intensity required to control symptoms and minimize risks. The criteria are simple and applicable to any level of care.
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