A guide for a patient-centric approach to asthma management - results of a European Delphi consensus programme

Sep 29, 2026

A European Delphi consensus programme developed patient-centric recommendations to support optimal inhaler treatment selection in asthma. The work synthesized evidence from PubMed and Cochrane literature published between 2014-01-01 and 2024-04-23, analyzing how patient factors affect adherence and asthma control and examining inhaler preference data. Fifty patients and 39 healthcare professionals participated in a two-round anonymous voting process, producing 20 consensus statements in four patient-centred care domains, with 18 achieving >85% agreement.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Background

Methods

Results

Conclusions

Introduction

[www.nature.com/npjpcrm](www.nature.com/npjpcrm) ARTICLE OPEN A guide for a patient-centric approach to asthma management: results of a European Delphi consensus programme Fulvio Braido 1 ✉ , Ilaria Baiardini2, Simona Barbaglia3, Susanna Palkonen4, Armando Ruiz5, Ioanna Tsiligianni6,7, Johann Christian Virchow8 and Tonya Winders9 | | Background: The Global Initiative for Asthma 2024 report recommends a shared decision-making approach to guide treatment choice, encompassing patients’ goals, beliefs and concerns about asthma and medications (GINA. Global Strategy for Asthma Management and Prevention, 2024) . There is limited guidance on ways to achieve this goal. This consensus programme aimed to create recommendations on optimal selection of inhaler treatment while considering patient perspectives and needs. Methods: A literature review was conducted on literature published between 01/01/2014 and 23/04/2024 using agreed keywords and search parameters in PubMed and Cochrane databases. Evidence on impact of patient factors on adherence and asthma control, plus inhaler preference data, was analysed. A consensus voting panel was selected via screening questionnaire, with 50 patients with asthma duration ≥5 years and 39 healthcare professionals with expertise in asthma from ﬁve European countries (Germany, France, Czechia, Italy, Greece) . A two-round Delphi method was used. Results: 40/135 papers were considered relevant. From these,
20 consensus statements were developed in four areas: patient-centred treatment selection, medication/asthma beliefs, patient preference + shared decision-making, and tools for patient-centred care. 18/20 consensus statements were accepted with an agreement threshold >85% on the ﬁrst round of voting. Two revised statements underwent a second Delphi round, again failing to reach consensus. Conclusions: This important initiative generated much-needed guidance on integrating patient views and needs into treatment decision-making following a well-established methodology through 18 consensus statements, with nearly equal | | | --- | --- | --- | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | input from patients and healthcare professionals. | | | | | npj Primary Care Respiratory Medicine (2026)36:2; [https://doi.org/10.1038/s41533-025-00465-3](https://doi.org/10.1038/s41533-025-00465-3) | | | | | | INTRODUCTION Successful asthma management requires treatment of both symptoms and underlying pathology, and inhaled therapies remain the mainstay of treatment1. As asthma is a lifelong condition, it is essential to select not only the right drug but also appropriate long-term holistic care. Medication adherence plays a key role in the success of any treatment and, for this reason, a patient-centred approach to treatment selection can be beneﬁcial since patients are more likely to adhere to their medication when they play a part in decision-making about their care2,3. The ‘right’approach is affected by multiple factors, including the patient’sage, literacy, health literacy, physical abilities, comorbidities, lifestyle, perceived stigma, and beliefs about their condition and medications2,4–15. Shared decision-making – involving the patient in decisions about their treatment – may be viewed as an ethical obligation as well as a means to improve medication adherence. This approach is being increasingly adopted in the management of many chronic health conditions, with varying degrees of success 16–20. In asthma, the details of what shared decisionmaking and personalising treatment look like in practice are not well deﬁned1, 3, 21. Guidelines provide broad recommendations without clear direction on their implementation, leaving the details of how to put recommendations into practice open to interpretation. This has led to various approaches with variable outcomes. A systematic review of the lite

FAQs

What was the purpose of the European Delphi consensus programme?

To create recommendations for selecting optimal inhaler treatment while incorporating patient perspectives, needs, and beliefs into asthma management decisions.

How was evidence gathered and used in the programme?

A literature review was conducted in PubMed and Cochrane databases for publications from 2014-01-01 to 2024-04-23, using agreed keywords and search parameters.

How many consensus statements were produced and accepted?

Twenty consensus statements were developed across four areas, and 18 were accepted after the first Delphi round with an agreement threshold greater than 85%.

Sep 29, 2026

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