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

Background: Acute 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.

Methods: To 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.

Results: The 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.

Conclusion: Our 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.

Aim

The primary aim of this paper is to describe the views of clinicians in identifying important
outcome measures. The secondary aim is to understand important research priorities and explore the underlying behaviours and knowledge used by clinicians to define,
treat and reassess asthma

Contributors

Charmaine S Gray, Yao Xu, Franz E Babl, Stuart Dalziel, Colin V E Powell, Shu-Ling Chong, Damian Roland, Mark D Lyttle, Ricardo M Fernandes, Javier Benito, Mike Johnson, Adriana Yock-Corrales, Indumathy Santhanam, Suzanne Schuh, Baljit Cheema, Jenny Couper, Simon Craig, On behalf of the Pediatric Emergency Research Network (PERN)

Publication

Journal: BMJ Open Respiratory Research
Volume: 10
Issue:
Pages: -
Year: 2023
DOI: 10.1136/bmjresp-2022-001502

Further Study Information

Current Stage: Completed
Date:
Funding source(s): This work is supported by the NHMRC Centre of Research Excellence in Paediatric Emergency Medicine (GNT1171228). SC’s contribution was funded by the Thoracic Society of Australia and New Zealand / National Asthma Council Fellowship, 2020: Generating new knowledge and seeking global consensus to inform future RCTs in acute severe paediatric asthma and the Australasian College for Emergecny Medicine Foundation Al Spilman Early Career Research Grant 2017. SRDs time was in part funded by Cure Kinds in New Zealand. FEB's time was funded by an NHMRC Investigator Leadership grant and the Royal Children's Hospital Foundation, PArkville, Australia


Health Area

Disease Category: Lungs & airways

Disease Name: Asthma

Target Population

Age Range: 0 - 18

Sex: Either

Nature of Intervention: Any

Stakeholders Involved

- Clinical experts

Study Type

- Recommendations made

Method(s)

- Interview

We conducted clinician interviews across multiple hospitals and countries and included multiple specialties. The focus was to understand how and why clinicians treat
asthma in the way they do, including identifying what clinicians perceive as important in both research questions and outcome measures.