Needs, limitations and opportunities to create a center of excellence for severe asthma care in the public healthcare system in Mexico

Abstract

Background: Asthma is a common chronic respiratory condition that affects from 1 to 18% of the world population. In Mexico, 8% of the population lives with asthma. Severe asthma represents up to 10% of cases. The proposal of an Asthma Center of Excellence has the main goal to develop key procedures, establishing methods and developing clinical experience based in modern technology and focused on critical procedures that allow institutions to build more efficient management procedures.

Objective: To bring to consensus the needs and opportunities identified in the public sector to create a center of excellence for severe asthma management.

Methodology: We used the RAND/UCLA method for consensus, through scientific evidence and the opinions of an asynchronous online modified Delphi panel of 14 experts from different institutions with experience in severe asthma management. Main recommendations: The panel provided considerations and recommendations to facilitate and standardize the diagnosis, management, treatment, and follow-up of patients with severe asthma, with particular emphasis on management of comorbidities, international considerations and strategies to evaluate treatment adherence and key resources for the development of a Center of Excellence.

Conclusion: The development of a Center of Excellence would allow to accelerate scientific innovation, education and advocacy, promoting excellence in education, research and training in the management of asthma.

Keywords: Asthma; Chronic respiratory condition; Severe asthma; Centers of excellence; Mexico; Public sector; Treatment adherence.