[MIA 2.0, Comprehensive asthma management, guidelines for Mexico].

Abstract

Background: In 2020, a multidisciplinary group developed Integrated Asthma Management (MIA), guidelines for asthma in Mexico, based on international asthma guidelines. Since then, several concepts and treatments have been updated.

Objective: To create a current version of MIA, strongly based on evidence, and to add the management of severe asthma exacerbations.

Methodology: MIA 2.0 uses the ADAPTE method. The MIA 2.0 guideline development group consists of a core group (experts in pulmonology-allergology-methodology) and representatives of 16 institutions/societies of specialties that manage asthma. The international reference guidelines (selected with AGREE-II) were: GINA 2024, GEMA 5.4, BTS/SIGN 2024 and Australian Asthma Handbook 2021. MIA 2.0 covers diagnosis, treatment, severe asthma, exacerbations and special groups. Key clinical questions were formulated for I) diagnosis, II) treatment steps 1-4, III) severe asthma and IV) exacerbations.

Results: Based on evidence in reference guidelines, safety, cost and local reality, the core group developed responses to the clinical questions. Through a Delphi process, the MIA 2.0 development group suggested adjustments until consensus was reached.

Conclusion: A document was generated with multiple figures and algorithms, about asthma management including exacerbations treatment, adjusted for Mexico broadly based among different societies that participated in its development.