Assessment of Severe Asthma Management Practices among Pulmonologists and Allergists

Abstract

Rationale: The objective of this study was to assess knowledge, competence and attitudes among pulmonologists and allergists regarding management of severe asthma. Methods: A continuing medical education (CME)-certified program consisting of 26 multiple-choice and Likert-scale questions derived from 2017 GINA recommendations (Global Strategy for Asthma Management and Prevention, 2017. Available from www.ginasthma.org) and literature, was hosted on the Medscape Education website. Participant responses were collected from June 29 to August 1, 2017. Confidentiality was maintained and responses were de-identified and aggregated prior to analyses. Results: 161 pulmonologists and 71 allergists participated. 58% of pulmonologists/75% of allergists self-reported high to very high levels of confidence in using guideline-based algorithms for treatment selection; yet only 35% of pulmonologists/51% of allergists are as confident in using asthma biomarkers. Assessing adherence to therapy is a first step for 83% of pulmonologists/75% of allergists in addressing poorly controlled symptoms; yet fewer than one-half of pulmonologists (44%) and allergists (45%) report assessing patient inhaler technique at each visit. 81% of pulmonologists/79% of allergists were unaware of detailed mechanisms of action regarding IL-5 targeted biologics. Fewer than one-half of clinicians assess asthma symptoms using a validated measurement scale at every visit; greater than one-quarter report using clinical impressions alone. Conclusion: Significant gaps regarding expert-recommended practices in severe asthma were identified among both groups. Educational interventions tailored to specific needs are warranted to address these gaps.