Multidisciplinary approaches to identifying and managing global airways disease: Expert recommendations based on qualitative discussions

Frontiers in Allergy

Allergy

Lauri Lehtimäki¹  Dan Weinfeld²  Sanna Toppila-Salmi³  Bernt Bøgvald Aarli⁴  Arild Danielsen⁵  Sverre Steinsvåg⁶  Sietze Reitsma⁷  Peter W. Hellings⁸  Kasper Aanæs⁹  Vibeke Backer⁹  Gert-Jan Braunstahl^1,10  Leif Bjermer^1,11  Charlotte Suppli Ulrik^1,12  Lars Olaf Cardell^1,13  Claus Bachert^1,14  Hannu Kankaanranta^1,15 

[1] Allergy Centre, Tampere University Hospital, Tampere, Finland;Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland;Asthma and Allergy Clinic Outpatient Unit (Adults), Department of Internal Medicine, South Alvsborgs Central Hospital, Boras, Sweden;Department of Allergology, Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland;Department of Clinical Science, University of Bergen, Bergen, Norway;Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway;Department of ENT & Allergy, The Multidisciplinary Clinic “BestHelse”, Oslo, Norway;Department of Otolaryngology, Head and Neck Surgery, Haukeland University Hospital, Bergen and Sørlandet Sykehus, Kristiandsand, Norway;Department of Otorhinolaryngology – Head and Neck Surgery, Amsterdam University Medical Centers, Location AMC, Amsterdam, Netherlands;Department of Otorhinolaryngology – Head and Neck Surgery, Amsterdam University Medical Centers, Location AMC, Amsterdam, Netherlands;Department of Otorhinolaryngology, University Hospitals Leuven, Leuven, Belgium;Department of Otorhinolaryngology, Upper Airways Disease Research Group, University of Ghent, Ghent, Belgium;Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark;Department of Pulmonology, Franciscus Gasthuis & Vlietland, Rotterdam, Netherlands;Department of Pulmonology, Erasmus Medical Center, Rotterdam, Netherlands;Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Lund, Sweden;Department of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Hvidovre, Denmark;Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark;Division of ENT Diseases, CLINTEC, Karolinska Institute, Stockholm, Sweden;Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden;Division of ENT Diseases, CLINTEC, Karolinska Institute, Stockholm, Sweden;Department of Otorhinolaryngology, Upper Airways Disease Research Group, University of Ghent, Ghent, Belgium;Department of Otorhinolaryngology, International Airway Research Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China;Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland;Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland;Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;

关键词: asthma;    nasal polyps;    respiratory hypersensitivity;    rhinitis;    sinusitis;    chronic rhinosinusitis with nasal polyps (CRSwNP);    global airways disease;    interdisciplinary care;   

DOI  :  10.3389/falgy.2023.1052386

 received in 2022-09-23, accepted in 2023-01-17,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundChronic rhinosinusitis with nasal polyps (CRSwNP) and asthma frequently co-exist and share pathologic features. Taking a “global” treatment approach benefits diagnosis and treatment of both, but care is often siloed by specialty: joined-up clinics are uncommon. Our objectives were to explore expert opinion to give practical suggestions to identify adults needing global airways care; enhance cross-specialty working; and widen knowledge to support diagnosis and management, integrate with existing care pathways, and supplement existing guidelines.MethodsSixteen practicing physicians from northern Europe were invited for their national and/or international standing in treating asthma and/or chronic rhinosinusitis. Appreciative Inquiry techniques were used to guide their discussions.ResultsKey themes arising were screening and referral, collaboration on management, awareness and education, and research. Provided are screening criteria and suggestions for specialist referrals, and pointers for physicians to optimize their knowledge of global airways disease. Collaborative working is underscored, and practical suggestions are given for multidisciplinary teamworking within global airways clinics. Research gaps are identified.ConclusionThis initiative provides practical suggestions for optimizing the care of adults with CRSwNP and asthma. Discussion of the role of allergy and drug exacerbations on these conditions, and care for patients with other global airways diseases were beyond scope; however, we expect some principles of our discussion will likely benefit patients with related conditions. The suggestions bridge asthma and CRSwNP management guidelines, envisioning interdisciplinary, global airway clinics relevant to various clinical settings. They highlight the value of joint screening for early recognition and referral of patients.

【 授权许可】

Unknown   
© 2023 Backer, Cardell, Lehtimäki, Toppila-Salmi, Bjermer, Reitsma, Hellings, Weinfeld, Aanæs, Ulrik, Braunstahl, Aarli, Danielsen, Kankaanranta, Steinsvåg and Bachert.