Recommendations for the prevention and diagnosis of asthma in children: Evidence from international guidelines adapted for Mexico

Publication date: Available online 26 December 2017
Source:Allergologia et Immunopathologia
Author(s): D.E.S. Larenas Linnemann, B.E. del Río Navarro, J.A. Luna Pech, J. Romero Lombard, J. Villaverde Rosas, M.C. Cano Salas, M. Fernández Vega, J.A. Ortega Martell, E.C. López Estrada, J.L. Mayorga Butrón, J. Salas Hernández, J.C. Vázquez García, I. Ortiz Aldana, M.H. Vargas Becerra, M. Bedolla Barajas, N. Rodríguez Pérez, A. Aguilar Aranda, C.A. Jiménez González, C. García Bolaños, C. Garrido Galindo, D.A. Mendoza Hernández, E. Mendoza López, G. López Pérez, G.H. Wakida Kuzonoki, H.H. Ruiz Gutiérrez, H. León Molina, H. Martínez de la Lanza, H. Stone Aguilar, J. Gómez Vera, J. Olvera Salinas, J.J. Oyoqui Flores, J.L. Gálvez Romero, J.S. Lozano Saenz, J.I. Salgado Gama, M.A. Jiménez Chobillon, M.A. García Avilés, M.P. Guinto Balanzar, M.A. Medina Ávalos, R. Camargo Angeles, R. García Torrentera, S. Toral Freyre, G. Montes Narvaez, H. Solorio Gómez, J. Rosas Peña, S.J. Romero Tapia, A. Reyes Herrera, F. Cuevas Schacht, J. Esquer Flores, J.A. Sacre Hazouri, L. Compean Martínez, P.J. Medina Sánchez, S. Garza Salinas, C. Baez Loyola, I. Romero Alvarado, J.L. Miguel Reyes, L.E. Huerta Espinosa, M.Á. Correa Flores, R. Castro Martínez
BackgroundWith the availability of high-quality asthma guidelines worldwide, one possible approach of developing a valid guideline, without re-working the evidence, already analysed by major guidelines, is the ADAPTE approach, as was used for the development of National Guidelines on asthma.MethodsThe guidelines development group (GDG) covered a broad range of experts from medical specialities, primary care physicians and methodologists. The core group of the GDG searched the literature for asthma guidelines 2005 onward, and analysed the 11 best guidelines with AGREE-II to select three mother guidelines. Key clinical questions were formulated covering each step of the asthma management.ResultsThe selected mother guidelines are British Thoracic Society (BTS), GINA and GEMA 2015. Responses to the questions were formulated according to the evidence in the mother guidelines. Recommendations or suggestions were made for asthma treatment in Mexico by the core group, and adjusted during several rounds of a Delphi process, taking into account: 1. Evidence; 2. Safety; 3. Cost; 4. Patient preference – all these set against the background of the local reality. Here the detailed analysis of the evidence present in BTS/GINA/GEMA sections on prevention and diagnosis in paediatric asthma are presented for three age-groups: children with asthma ≤5 years, 6–11 years and ≥12 years.ConclusionsFor the prevention and diagnosis sections, applying the AGREE-II method is useful to develop a scientifically-sustained document, adjusted to the local reality per country, as is the Mexican Guideline on Asthma.



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