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Journal of Allergy and Infectious Diseases

ISSN: 2692-6334

Short Communication Open Access
Volume 4 | Issue 1 | DOI: https://doi.org/10.46439/allergy.4.033

Building and implementing best practices for referral and management of severe asthma in Canadian healthcare

Godbout K1, Bhutani M2, Connors L3, Chan CKN4,*, Connors C5, Dorscheid D6, Dyck G7, Kaplan AG8, Reynolds J9, Waserman S10
  • 1Quebec Heart and Lung Institute, Laval University, Quebec City, Canada
  • 2Department of Medicine, Division of Pulmonary Medicine, University of Alberta, Western Canada, AB, Canada
  • 3Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
  • 4Faculty of Medicine, University of Toronto, Toronto, ON, Canada
  • 5Executive Director, Canadian Network for Respiratory Care.
  • 6Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC V6Z 1Y6, Canada
  • 7Clearspring Medical Clinic, Steinbach, Manitoba, Canada.
  • 8Family Physician Airways Group of Canada, Respiratory Effectiveness Group, Department of Family and Community Medicine, University of Toronto, L4G 1N2, Canada
  • 9Director, Programs and Services, Asthma Canada, Toronto, Ontario, M4S 2Z2, Canada
  • 10Department of Medicine, Clinical Immunology and Allergy, McMaster University, Hamilton, Ontario, Canada
+ Affiliations - Affiliations

Corresponding Author

Chan CKN, charles.chan@onelinkconnect.com

Received Date: April 18, 2023

Accepted Date: April 24, 2023

Citation:

Godbout K, Bhutani M, Connors L, Chan CKN, Connors C, Dorscheid D, et al. Building and implementing best practices for referral and management of severe asthma in Canadian healthcare. J Allergy Infect Dis. 2023;4(1):4-8.


Copyright: © 2023 Godbout K, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: Despite adherence to maximal inhaled therapy, 5-10% of asthma patients in Canada still suffer from poorly controlled symptoms. These severe asthma patients have frequent exacerbations as well as increased morbidity and mortality, not only associated with the disease but in some cases the medications used to treat it. Asthma patients often rely on the use of short-acting beta-2 agonists and oral corticosteroids to manage their symptoms on a day-to-day basis. Overuse of these medications is problematic, as patients are at an increased risk of treatment related side effects. Overuse also suggests uncontrolled asthma which could be due to the presence of undiagnosed severe asthma. The objective of this commentary is to describe the asthma crisis in Canada, followed by  consensus-based recommendations on best practices for its treatment and management, and their implementation.
Consensus Recommendations: Previous consensus-based research has highlighted areas where changes in care are most required. Core recommendations from this research aim to shift care to a more proactive approach, where healthcare providers think critically about patients whose asthma is not well controlled in addition to educating patients on their condition, and empowering them to seek care if their symptoms worsen.
Implementing Change: To successfully implement the proposed changes will require a concerted effort from all stakeholders. The core recommendations can be actioned at each level of the healthcare pathway, and include input from respiratory specialists (including respirologists, allergists, respiratory educators), nurses, pharmacists, general practitioners, and patients. 
Conclusions: The core recommendations outlined can be easily implemented across the asthma and severe asthma treatment pathways in Canada. Taking a more proactive approach to severe asthma has the potential to improve patient  outcomes through earlier diagnosis and treatment, whilst alleviating pressure on the health system. 

Keywords

Best practice, Biologics, Consultation and referral, Primary care, Health care, Canada

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