Recommendations for quality care indicators in severe asthma multidisciplinary units in Portugal (PRECISION project): A nationwide consensus.

Authors

Carlos Lopes, Filipa Duarte-Ramos, João Marques, Inês Belchior, Ana Mendes, Ricardo Lima, Fernanda Tonin, Claudia Chaves Loureiro

Published in

Pulmonology. Volume 32. Issue 1. Pages 2703888. Epub Jul 31, 2026.

Abstract

Although severe asthma multidisciplinary units (SAMUs) are increasingly important for providing comprehensive, patient-centred care, quality metrics to assess their impact remain insufficient. We aimed to develop consensus-based recommendations for key performance indicators (KPIs) for SAMUs in Portugal.
A modified three-round Delphi study was performed (May-October 2024). The scientific committee developed 54 initial statements covering seven domains: I - Referral; II - Diagnosis; III - Treatment; IV - Monitoring; V - Administrative Tasks; VI - Nursing Care; VII - Research/Training. Participants rated agreement on a 5-point Likert scale, with consensus threshold of ≥90% (round 1) and ≥85% (round 2).The level of consensus achieved was discussed by the scientific committee.
Forty-five out of 56 invited experts completed the exercise (80.4% response rate). Round 1 achieved consensus on 28/54 statements (51.9%), mostly on treatment (70%) and monitoring (69.2%) items. Moderate consensus was found on referral (50%) and diagnosis (42.9%). In round 2, half of the remaining items ( 13/26) achieved agreement. Statements not reaching consensus were mostly from Research and Training (50%). Only one item from Diagnosis (14.3%) and one - Monitoring (7.7%) didn't achieve consensus.
While SA experts in Portugal reached consensus on KPIs for SAMUs related to innovative treatment, monitoring and administrative tasks, challenges persist in the areas of telemedicine, research/training, nursing care and patient referral. Standardising practices, improving access to target therapies, and adapting global metrics to the local context, could provide clearer guidance for developing future SAMU quality frameworks.

PMID:
42536117
Bibliographic data and abstract were imported from PubMed on 31 Jul 2026.

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