Keywords: asthma, disease management, specialization, primary care physicians, referralĪsthma is a chronic inflammatory disease of the airway that affects between 235 and 300 million people worldwide, with ~250,000 annual deaths worldwide attributed to this disease. Furthermore, we highlight why referrals are not happening, how this can be improved, and ultimately, what should be done in the specialist setting, based on existing evidence in published literature. In this review, recommendations for specialist referrals from several key international and national asthma guidelines and other relevant published literature are evaluated. Hurdles in implementing these recommendations include lack of their dissemination among health care providers and nonadherence to these guidelines these hurdles considerably limit the implementation of specialist referrals, eventually affecting the rate of referrals. Such referrals can help in clearing the uncertainty from the initial diagnosis, provide tailored treatment options to patients with persistent symptoms and offer the patients access to health care providers with expertise in the management of the asthma thus, specialist referrals have a substantial impact on disease prognosis and the patient’s health status. To help attain the best possible clinical outcomes in patients with asthma, several guidelines provide recommendations for patients who will require a referral to a specialist.
David Price, 1,2 Leif Bjermer, 3 David A Bergin, 4 Rafael Martinez 5ġCentre of Academic Primary Care, University of Aberdeen, Aberdeen, UK 2Observational and Pragmatic Research Institute, Singapore 3Department of Respiratory Medicine and Allergology, Lund University, Lund, Sweden 4Novartis Ireland Limited, Dublin, Ireland 5Novartis Pharma AG, Basel, SwitzerlandĪbstract: Heterogeneity of asthma and difficulty in achieving optimal control are the major challenges in the management of asthma.
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