ISSN: 1859 - 2872
Development of quality indicators for outpatient asthma management in Vietnam based on a systematic review and expert consensus
Main Article Content
Keywords
Abstract
Objective: To develop a set of quality indicators for outpatient asthma management based on the best available evidence and tailored to clinical practice in Vietnam. Subject and method: The study was conducted in four steps: (1) A systematic review of studies published between 2010 and 2025 to identify potential quality indicators; (2) Comparison of the identified indicators with the Vietnamese Ministry of Health guidelines and GINA recommendations to develop a draft indicator set; (3) Assessment of the appropriateness and necessity of each indicator by a multidisciplinary expert panel consisting of nine members (six respiratory physicians and three clinical pharmacists); and (4) finalization of the indicator set. Result: The systematic review identified 16 eligible studies, from which 164 potential quality indicators were extracted. Following screening and comparison with current clinical practice guidelines, 26 indicators were selected for the draft indicator set. Of the 26 draft indicators, 25 met the selection criteria based on expert assessment, while one indicator was retained following further review by the research team, considering its necessity and alignment with clinical practice guidelines. The final set comprised 26 indicators across five domains: Assessment and classification (3 indicators), pharmacological management (13), non-pharmacological management (3), exacerbation management (1), and patient follow-up (6). Conclusion: A set of 26 evidence-based quality indicators for outpatient asthma management was successfully developed through expert consensus. This indicator set provides a practical tool for assessing, monitoring, and improving the quality of outpatient asthma care in Vietnam.
Article Details
References
2. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. 2025. https://ginasthma.org
3. To T, Guttmann A, Lougheed MD et al (2010) Evidence-based performance indicators of primary care for asthma: A modified RAND Appropriateness Method. International Journal for Quality in Health Care 22(6): 476-485.
4. Ruiz-Canela-Cáceres J, Aquino-Llinares N, Sánchez-Diaz J, García-Gestoso M, de Jaime-Revuelta M, Praena-Crespo M (2015) Indicators for childhood asthma in Spain, using the Rand method. Allergologia et immunopathologia 43(2): 147-156.
5. Backer V, Lykkegaard J, Bodtger U, Agertoft L, Korshoej L, Braüner EV (2016) The Danish National Database for Asthma. Clin Epidemiol 8: 601-606. doi:10.2147/clep.S99494
6. Bộ Y tế (2023) Quyết định số 4032/QĐ-BYT ngày 01/11/2023 về việc ban hành thí điểm “Tiêu chí đánh giá chất lượng dịch vụ chẩn đoán, điều trị, quản lý hen phế quản và bệnh phổi tắc nghẽn mạn tính”.
7. Quirce S, Delgado J, Entrenas LM et al (2017) Quality indicators of asthma care derived from the Spanish guidelines for asthma management (GEMA 4.0): A multidisciplinary team report. Journal of investigational allergology & clinical immunology 27(1): 69-73.
8. Hansen S, Hoffmann-Petersen B, Sverrild A et al The Danish National Database for Asthma: establishing clinical quality indicators. European Clinical Respiratory Journal 3(1): 33903.
9. Steppuhn H, Langen U, Mueters S et al (2016) Asthma management practices in adults-findings from the German Health Update (GEDA) 2010 and the German National Health Interview and Examination Survey (DEGS1) 2008-2011. J Asthma 53(1): 50-61. doi:10.3109/02770903.2015.1059853
10. Sullivan PW, Ghushchyan V, Kavati A, Navaratnam P, Friedman HS, Ortiz B (2019) Trends in Asthma Control, Treatment, Health Care Utilization, and Expenditures Among Children in the United States by Place of Residence: 2003-2014. J Allergy Clin Immunol Pract 7(6): 1835-1842.e2. doi:10.1016/j.jaip.2019.01.055
11. Slejko JF, Ghushchyan VH, Sucher B et al (2014) Asthma control in the United States, 2008-2010: indicators of poor asthma control. J Allergy Clin Immunol. 133(6): 1579-1587. doi:10.1016/j.jaci.2013.10.028
12. Zeiger RS, Schatz M, Li Q, Chen W, Khatry DB, Tran TN (2017) Burden of Chronic Oral Corticosteroid Use by Adults with Persistent Asthma. J Allergy Clin Immunol Pract 5(4): 1050-1060. doi:10.1016/j.jaip.2016.12.023
13. Gonzales-Javier GTK, Dans LF, Tanega-Aliling K, et al (2025) Clinical Profile and Prescribing Patterns of Therapy in Children with Bronchial Asthma in a Rural Site in the Philippines: A Retrospective Cohort Study. Acta Med Philipp 59(1): 84-90. doi:10.47895/amp.vi0.8536
14. Khakban A, FitzGerald JM, Tavakoli H, Lynd L, Ehteshami-Afshar S, Sadatsafavi M (2019) Extent, trends, and determinants of controller/reliever balance in mild asthma: A 14-year population-based study. Respir Res 20(1): 44. doi:10.1186/s12931-019-1007-0
15. Sadatsafavi M, Tavakoli H, Lynd L, FitzGerald JM (2017) Has asthma medication use caught up with the evidence?: A 12-year population-based study of trends. Chest 151(3): 612-618.
16. Cicutto L, Dingae MB, Langmack EL (2014) Improving asthma care in rural primary care practices: A performance improvement project. J Contin Educ Health Prof. Fall 34(4): 205-214. doi:10.1002/chp.21254
17. To T, Guan J, Zhu J et al (2015) Quality of asthma care under different primary care models in Canada: A population-based study. BMC Family Practice 16(1): 19.
18. Arnlind MH, Wettermark B, Nokela M, Hjemdahl P, Rehnberg C, Jonsson EW (2010) Regional variation and adherence to guidelines for drug treatment of asthma. Eur J Clin Pharmacol 66(2): 187-198. doi:10.1007/s00228-009-0731-7
19. Hull SA, McKibben S, Homer K, Taylor SJ, Pike K, Griffiths C (2016) Asthma prescribing, ethnicity and risk of hospital admission: An analysis of 35,864 linked primary and secondary care records in East London. NPJ Prim Care Respir Med 26:16049. doi:10.1038/npjpcrm.2016.49
Article Sidebar
