Managing patients with severe asthma in Australia

Current challenges with the existing models of care

Li Ping Chung, Mark Hew, Philip Bardin, Vanessa M. McDonald, John W. Upham

Research output: Contribution to journalArticleOtherpeer-review

3 Citations (Scopus)

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 languageEnglish
Pages (from-to)1536-1541
Number of pages6
JournalInternal Medicine Journal
Volume48
Issue number12
DOIs
Publication statusPublished - 1 Dec 2018

Keywords

  • asthma
  • challenges
  • difficult-to-treat
  • poor control
  • severe
  • specialised care

Cite this

@article{e4093b23d4694455869eaac2c6ea73b1,
title = "Managing patients with severe asthma in Australia: Current challenges with the existing models of care",
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.",
keywords = "asthma, challenges, difficult-to-treat, poor control, severe, specialised care",
author = "Chung, {Li Ping} and Mark Hew and Philip Bardin and McDonald, {Vanessa M.} and Upham, {John W.}",
year = "2018",
month = "12",
day = "1",
doi = "10.1111/imj.14103",
language = "English",
volume = "48",
pages = "1536--1541",
journal = "Internal Medicine Journal",
issn = "1444-0903",
publisher = "Wiley-Blackwell",
number = "12",

}

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 journalArticleOtherpeer-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 -