Enhancing asthma care in Kuwait: insights from a modified Delphi-based consensus on the Global Initiative for Asthma 2022 guidelines and management practices

Abstract

Aim: Asthma represents a significant health burden in Kuwait, with high prevalence rates among adults and children. Most asthma patients rely on government healthcare facilities for management, so there is a pressing need to optimize asthma care and treatment strategies. A cross-sectional paper-based survey was conducted to gather insights from allergists and pulmonologists across various healthcare facilities in Kuwait. Methods: Twenty-six medical professionals participated, sharing their perspectives on asthma management practices and adherence to the Global Initiative for Asthma (GINA) 2022 guidelines through answering a modified single round Delphi survey. Results: A high level of consensus on the practicality of guideline changes and the importance of spirometry in diagnosis were reported. However, agreement varied regarding optimal management strategies and medication preferences, indicating areas of divergence among experts. Notably, while there was strong support for inhaled corticosteroid (ICS)-long-acting β2 agonist (LABA) therapy during exacerbations, opinions differed on the use of short-acting β2 agonist (SABA) inhalers as rescue medication. Additionally, the study highlighted challenges in achieving higher levels of agreement, particularly regarding the frequency of inhaler technique checks and specialist referrals for severe asthma cases. Conclusions: This study provided valuable insights into current asthma management practices in Kuwait and identified opportunities for consensus-driven strategies aligned with GINA guidelines. By incorporating diverse perspectives from expert allergists and pulmonologists, it contributed to the enhancement of asthma care and patient outcomes in Kuwaiti healthcare settings.