Severe asthma affects an estimated 5 to 10% of people with asthma in Canada, yet accounts for around half of all direct asthma-related costs. Care is delivered inconsistently: access to specialist services and biologic treatments varies, and continued reliance on short-acting beta agonists and oral corticosteroids often signals disease that is undiagnosed or not yet optimally treated. Parts of the severe asthma pathway sit ahead of the available evidence.
To define standards of care across that pathway, an expert steering group of asthma clinicians developed 43 consensus statements spanning eight themes, from referral criteria to patient empowerment. The statements were tested through a modified Delphi consensus, using an online questionnaire completed by 150 healthcare professionals across Canada, including respirologists, allergists, family physicians, nurses and pharmacists. Consensus was pre-specified at 75% agreement, with very high agreement set at 90%.
Forty-one of the 43 statements reached consensus, 37 of them at very high agreement. The resulting ten recommendations set concrete expectations: diagnostic tools such as spirometry available within four weeks of request, and biologic therapy initiated within two to four weeks of approval.
Triducive acted as the independent facilitator for this modified Delphi consensus, identifying the key topics, generating the statements and providing medical writing support. The result is the first Canadian stakeholder consensus on diagnosing, referring and treating severe asthma.
Godbout K, et al. Allergy, Asthma & Clinical Immunology, 2023. DOI: 10.1186/s13223-023-00767-6
