Journal of Asthma and Allergy (Aug 2019)
Approaches to the assessment of severe asthma: barriers and strategies
Abstract
Eleanor C Majellano,1,2 Vanessa L Clark,1,2 Natasha A Winter,1,3 Peter G Gibson,1,4 Vanessa M McDonald1,2,41Faculty of Health and Medicine, National Health and Medical Research Council Centre for Research Excellence in Severe Asthma and the Priority Research Centre for Healthy Lungs, The University of Newcastle, Newcastle, NSW, Australia; 2Faculty of Health and Medicine, School of Nursing and Midwifery, The University of Newcastle, Newcastle, NSW, Australia; 3Faculty of Health and Medicine, School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia; 4Department of Respiratory and Sleep Medicine, John Hunter Hospital, Hunter Medical Research Institute, Newcastle, NSW, AustraliaCorrespondence: Vanessa M McDonaldLevel 2 West Wing, Hunter Medical Research Institute, Locked Bag 1000, New Lambton Heights, NSW 2305, AustraliaTel +61 24 042 0146Fax +61 4 042 0046Email [email protected]: Asthma is a chronic condition with great variability. It is characterized by intermittent episodes of wheeze, cough, chest tightness, dyspnea and backed by variable airflow limitation, airway inflammation and airway hyper-responsiveness. Asthma severity varies uniquely between individuals and may change over time. Stratification of asthma severity is an integral part of asthma management linking appropriate treatment to establish asthma control. Precision assessment of severe asthma is crucial for monitoring the health of people with this disease. The literature suggests multiple factors that impede the assessment of severe asthma, these can be grouped into health care professional, patient and organizational related barriers. These barriers do not exist in isolation but interact and influence one another. Recognition of these barriers is necessary to promote precision in the assessment and management of severe asthma in the era of targeted therapy. In this review, we discuss the current knowledge of the barriers that impede assessment in severe asthma and recommend potential strategies for overcoming these barriers. We highlight the relevance of multidimensional assessment as an ideal approach to the assessment and management of severe asthma.Keywords: asthma, severe asthma, severity, assessment, barriers, strategies
