Abstract
Severe asthma leads to debilitating symptoms for patients and excessive socioeconomic burden for the community. Comprehensive models of care are required to address complex issues, risk factors and comorbidities in patients with severe asthma, and to identify patients most appropriate for specialised treatments. Dedicated severe asthma services improve asthma control, reduce asthma exacerbations and hospital admissions, and improve quality of life. Currently, diverse models of care exist for managing severe asthma across Australia. Most referrals to severe asthma services are from respiratory physicians seeking a second opinion or from primary care for poorly controlled asthma. Despite benefits of specialised severe asthma services, many patients are not referred and resources are limited, often resulting in long waiting times. Patient referral is often unstructured and there are considerable variations in the management of severe asthma with limited access to other health care professionals such as speech pathologists and dieticians, and restricted scope to optimise patient work-up before referral. Ongoing communication between the specialist and referring clinician is essential for continuity of care but is often lacking. Referral pathways can be optimised by developing referral criteria and guidelines to triage patients with severe asthma and to improve resource efficiency. Additional education and tools for assessing and managing severe asthma are needed, and mechanisms should be developed for involving primary care in the management of stabilised patients. Strategies to increase patient access to multidisciplinary services are recommended.
| Original language | English |
|---|---|
| Pages (from-to) | 1536-1541 |
| Number of pages | 6 |
| Journal | Internal Medicine Journal |
| Volume | 48 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - 1 Dec 2018 |
Keywords
- asthma
- challenges
- difficult-to-treat
- poor control
- severe
- specialised care
Cite this
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Managing patients with severe asthma in Australia : Current challenges with the existing models of care. / Chung, Li Ping; Hew, Mark; Bardin, Philip; McDonald, Vanessa M.; Upham, John W.
In: Internal Medicine Journal, Vol. 48, No. 12, 01.12.2018, p. 1536-1541.Research output: Contribution to journal › Article › Other › peer-review
TY - JOUR
T1 - Managing patients with severe asthma in Australia
T2 - Current challenges with the existing models of care
AU - Chung, Li Ping
AU - Hew, Mark
AU - Bardin, Philip
AU - McDonald, Vanessa M.
AU - Upham, John W.
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Severe asthma leads to debilitating symptoms for patients and excessive socioeconomic burden for the community. Comprehensive models of care are required to address complex issues, risk factors and comorbidities in patients with severe asthma, and to identify patients most appropriate for specialised treatments. Dedicated severe asthma services improve asthma control, reduce asthma exacerbations and hospital admissions, and improve quality of life. Currently, diverse models of care exist for managing severe asthma across Australia. Most referrals to severe asthma services are from respiratory physicians seeking a second opinion or from primary care for poorly controlled asthma. Despite benefits of specialised severe asthma services, many patients are not referred and resources are limited, often resulting in long waiting times. Patient referral is often unstructured and there are considerable variations in the management of severe asthma with limited access to other health care professionals such as speech pathologists and dieticians, and restricted scope to optimise patient work-up before referral. Ongoing communication between the specialist and referring clinician is essential for continuity of care but is often lacking. Referral pathways can be optimised by developing referral criteria and guidelines to triage patients with severe asthma and to improve resource efficiency. Additional education and tools for assessing and managing severe asthma are needed, and mechanisms should be developed for involving primary care in the management of stabilised patients. Strategies to increase patient access to multidisciplinary services are recommended.
AB - Severe asthma leads to debilitating symptoms for patients and excessive socioeconomic burden for the community. Comprehensive models of care are required to address complex issues, risk factors and comorbidities in patients with severe asthma, and to identify patients most appropriate for specialised treatments. Dedicated severe asthma services improve asthma control, reduce asthma exacerbations and hospital admissions, and improve quality of life. Currently, diverse models of care exist for managing severe asthma across Australia. Most referrals to severe asthma services are from respiratory physicians seeking a second opinion or from primary care for poorly controlled asthma. Despite benefits of specialised severe asthma services, many patients are not referred and resources are limited, often resulting in long waiting times. Patient referral is often unstructured and there are considerable variations in the management of severe asthma with limited access to other health care professionals such as speech pathologists and dieticians, and restricted scope to optimise patient work-up before referral. Ongoing communication between the specialist and referring clinician is essential for continuity of care but is often lacking. Referral pathways can be optimised by developing referral criteria and guidelines to triage patients with severe asthma and to improve resource efficiency. Additional education and tools for assessing and managing severe asthma are needed, and mechanisms should be developed for involving primary care in the management of stabilised patients. Strategies to increase patient access to multidisciplinary services are recommended.
KW - asthma
KW - challenges
KW - difficult-to-treat
KW - poor control
KW - severe
KW - specialised care
UR - http://www.scopus.com/inward/record.url?scp=85057750446&partnerID=8YFLogxK
U2 - 10.1111/imj.14103
DO - 10.1111/imj.14103
M3 - Article
VL - 48
SP - 1536
EP - 1541
JO - Internal Medicine Journal
JF - Internal Medicine Journal
SN - 1444-0903
IS - 12
ER -