Response to Level of Compliance with Spanish Guideline Recommendations in the Management of Asthma [Letter]

Dear Editor

Carefully reading the research from Lorena Piñel Jimenez et al¹ entitled 'Level of Compliance with Spanish Guideline Recommendations in the Management of Asthma' gives an idea that this study is good This study provides an overview of the clinical management of asthma patients, a better understanding of compliance levels, and recommendations for training development. This research helps to improve understanding of the application of clinical guidelines and provides clear directions to improve the quality of asthma care.

In addition, this study also has many shortcomings; especially, this research uses a retrospective design, which often faces problems related to existing data collection. This can lead to incomplete or poorly recorded data, so there may be bias in the research results. This is similar to the research conducted by Norihiro Harada et al² using retrospective research with a cohort study analyzed data from the Real-World Data database, a very complete medical record database. In addition, one of the weaknesses revealed is the low level of adherence to the use of spirometry for the diagnosis of asthma (only 20.8% of patients undergo this test). This indicates that the diagnostic method may not have been implemented optimally in the field, which can affect the accuracy of the diagnosis. This is in line with research conducted by Qais Alefan et al³ showing that adherence to lifestyle will play a significant role in the incidence of hypertension.

Another drawback is that the study was only conducted in the area of influence of the Universitario Virgen de la Victoria Hospital in Málaga, Spain. Although the results are considered representative for the region, they cannot be generalized to populations in other regions that have different demographic characteristics or health care systems. This is in line with Benjamin Anderson⁴ that in order for a sample to be representative, it must have the same characteristics as the population.

To follow the advice given, it is hoped that this study will be more perfect and that this research can be more methodologically robust, provide more reliable results, and ultimately improve asthma management in the field.