Ongoing Task Forces

Understanding and adherence to international guidelines in the management of stable asthma by different specialties. Ιndications for specialist referral

1.    Rational for establishing the Task Force:
Asthma is a common, chronic respiratory disease, which affects all age groups and causes significant morbidity, mortality, health resource utilization and poor quality of life. Globally its prevalence varies widely between 1% and 21%, while studies suggest it is still underdiagnosed to a large extent, which may reach 70% of asthma patients above the age of 40 years. The most recent data from the Global Burden of Disease suggested an increasing mortality and disability-adjusted life years (DALYs) associated with asthma, between 2005 and 2010, in contrast to the previous declining trend. Asthmatic patients are estimated to be at up to 30% higher risk of death compared to healthy subjects  and, sadly, two thirds of these deaths may be preventable. Therefore, asthma is a serious global health problem that is still underdiagnosed and undertreated.
Diagnosis, assessment and management of asthma can be challenging. Recent developments in the field, which urged updates to the Global Strategy for Asthma Management and Prevention (GINA guidelines), further complicate them. Several phenotypes have been identified that require different therapeutic approach. Additional pharmacologic classes, such as Long-Acting Muscarinic Antagonists (LAMAs), were found to be effective and are now indicated in asthma treatment. Moreover, owing to the complexity of the disease, a multidisciplinary approach is considered beneficial, especially in poorly controlled cases, but it is not adequately implemented globally, yet. The burden of Asthma-Chronic Obstructive Pulmonary Disease (COPD) overlap syndrome is increasingly recognised. On the other hand, due to the high prevalence of the disease and co-existence with other diseases, several different medical specialties manage patients with asthma across Europe. These include respiratory physicians, general physicians, allergologists and general practitioners.
Recent studies and audits suggest poor adherence to the international guidelines and inconsistent therapeutic results, both in the longterm management of stable asthma and in the management of acute exacerbations, causing preventable morbidity and mortality. It has also been suggested that the diagnostic accuracy and adherence to guidelines is more problematic among general physicians and in primary care. Both GINA and SIGN guidelines have clear recommendations to refer patients with difficult to treat asthma (step 5 treatment) to a specialised asthma clinic. However, the understanding and adherence to the newer international asthma guidelines by professionals of different specialties who manage patients with asthma has not been assessed. We aim to assess whether asthmatic patients receive the appropriate level of care and how this could be improved. More specifically, we aim to assess whether there are differences in the quality of care provided by specialists versus generalists and whether these differences could be narrowed by training.

2.    Aims:
i.    To assess understanding and adherence to the newer international guidelines in the management of asthma among professionals with different specialties (eg. Respiratory and General Physicians, General Practitioners and Allergologists).
ii.    To assess how the level of care could be improved.

3.    Members of the TF:
-    Chairperson: Olympia Tsilochristou, MD, PhD st, EAACI JM Chair & Website Coordinating Editor, Charite University Hospital, Berlin, Germany, This email address is being protected from spambots. You need JavaScript enabled to view it.
-    Secretary: Alexander Mathioudakis, MD, EAACI JM & ERS Junior Representative of Group 5.1 (Airway Pharmacology & Treatment) & Coordinator of the EAACI-ERS Juniors’ collaboration, Aintree University Hospitals NHS Trust, Longmoor Lane, Liverpool, UK, This email address is being protected from spambots. You need JavaScript enabled to view it.

EAACI:
A.    Silvia Sanchez Garcia, Spain, EAACI Asthma Section JM Representative
B.    Nino Lomidze, Georgia, EAACI Primary Care IG JM Representative
C.    Ioana Agache, Romania, EAACI VP Communications & Membership
D.    Ömer Kalayci, Turkey, EAACI Asthma Section Chair
E.    Leif Bjermer, Sweden, EAACI Asthma Section Past-Chair
F.    Dermot Ryan, UK, EAACI Primary Care IG Chair
G.    Nikolaos Papadopoulos, Greece, EAACI Past-President

ERS:
H.    Anders Bjerg, Sweden, ERS Juniors Chair
I.    Andras Bikov, Hungary, ERS Airway Diseases Assembly Junior Member Representative
J.    Ian Adcock, UK, ERS Airway Diseases Assembly Chair
K.    Enrico Clini, Italy, ERS Clinical Assembly Chair
L.    Christen Janson, Sweden, ERS Occupation and Epidemiology Assembly Secretary
M.    Felix Herth, ERS Clinical Assembly Head Elect
N.    Ildiko Horvath, Hungary, ERS Airways Assembly Past Chair & Assessments Director Elect

IPCRG:
O.     Jaime Correia de Sousa, Portugal, IPCRG President Elect
Last updated 21 January 2016