International perspective on research priorities and outcome measures of importance in the care of children with acute exacerbations of asthma: a qualitative interview study

Abstract

BackgroundAcute exacerbations of asthma are common in children, however, treatment decisions for severe exacerbations are challenging due to a lack of robust evidence. In order to create more robust research, a core set of outcome measures needs to be developed. In developing these outcomes, it is important to understand the views of clinicians who care for these children in particular, views that relate to outcome measures and research priorities.MethodsTo determine the views of clinicians, a total of 26 semistructured interviews based on the theoretical domains framework were conducted. These included experienced clinicians from emergency, intensive care and inpatient paediatrics across 17 countries. The interviews were recorded, and later transcribed. All data analyses were conducted in Nvivo by using thematic analysis.ResultsThe length of stay in hospital and patient-focused parameters, such as timing to return to school and normal activity, were the most frequently highlighted outcome measures, with clinicians identifying the need to achieve a consensus on key core outcome measure sets. Most research questions focused on understanding the best treatment options, including the role of novel therapies and respiratory support.ConclusionOur study provides an insight into what research questions and outcome measures clinicians view as important. In addition, information on how clinicians define asthma severity and measure treatment success will assist with methodological design in future trials. The current findings will be used in parallel with a further Paediatric Emergency Research Network study focusing on the child and family perspectives and will contribute to develop a core outcome set for future research.

Core outcomes and factors influencing the experience of care for children with severe acute exacerbations of asthma: a qualitative study

“…A Delphi survey is planned4 to be conducted across the global PERN network, with input from clinicians, researchers, patients and families. The first round will present clinical outcomes identified in this study, a related study of clinicians,13 and a recent systematic review1 conducted by our group. Further rounds are planned to achieve consensus on a COS, which will then inform the design of future multicentre randomised clinical trials.…”

Global respiratory health priorities at the beginning of the 21st century

“…Acute exacerbations of asthma are common in children and treatment decisions for severe exacerbations are challenging [ 45 ]. To address this problem, the Pediatric Emergency Research Network proposed that a core set of outcome measures needs to be developed and they devised a study to identify research questions and outcome measures that clinicians view as important [ 46 ]. Among the findings, the most frequent outcome measures were the length of stay in hospital and timing to return to school and normal activity, with agreement across stakeholders on the need to achieve a consensus on key core outcome measures.…”