JCM, Vol. 14, Pages 8640: Vietnamese Consensus on the Structure and Content of Asthma Action Plan

Journal of Clinical Medicine doi: 10.3390/jcm14248640

Authors:
Quan Vu Tran Thien
Tho Nguyen Van
Quyen Thi Le Pham
Linh Duong Thi Chuc
Cong Nguyen Hai
Tuan Tran Trong Anh
Khai Ho Quoc
Huong Hoang Thi Lan
Lan Le Thi Tuyet

Background/Objectives: Asthma action plans (AAPs) are recommended for patients’ self-management of asthma and should be adapted to a country’s situation. This study aimed to develop expert consensus on the optimal structure, content, and action of asthma action plans for Vietnamese settings to ensure feasibility, acceptance, and implementation. Methods: A Delphi consensus was conducted over two rounds. The proposed items were evaluated by a Vietnamese panel of pulmonologists, allergists, tuberculosis/lung disease specialists, and general practitioners. Structured online questionnaires with five-point Likert scales were used. Consensus was defined as >80% agreement and <10% strong disagreement. Results: A total of 26 and 21 participants completed round 1 and round 2, respectively. The 4-zone format of AAP was preferred (42.3%) over the 3-zone (38.5%) or 2-zone (19.2%) formats. The AAP should include some key statements for asthma, symptoms for self-monitoring, an objective asthma control questionnaire, actions for changes in maintenance medication, and instructions in emergency situations. AAP zones should be classified by symptom frequency and severity. Patient actions should be tailored to their treatment regimen (MART or ICS/LABA + SABA). The APP might not include peak expiratory flow monitoring and oral corticosteroid self-administration for both the MART and ICS/LABA + SABA regimens and might not add SABA together with ICS dose escalation for the ICS/LABA + SABA regimen. Conclusions: This study established an expert consensus on fundamental AAP structural elements and actions for the Vietnamese. The failure to achieve consensus on PEF monitoring tools and OCS for the self-management of asthma exacerbation reflects concerns about medication abuse, especially in Vietnamese healthcare settings.

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