Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Jul 25:10:209-223.
doi: 10.2147/JAA.S134300. eCollection 2017.

Asthma referrals: a key component of asthma management that needs to be addressed

David Price  1   2 , Leif Bjermer  3 , David A Bergin  4 , Rafael Martinez  5
Affiliations
Review

Asthma referrals: a key component of asthma management that needs to be addressed

David Price et al. J Asthma Allergy. .

Abstract

Heterogeneity of asthma and difficulty in achieving optimal control are the major challenges in the management of asthma. 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. 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. 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. In this review, recommendations for specialist referrals from several key international and national asthma guidelines and other relevant published literature are evaluated. 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.

Keywords: asthma; disease management; primary care physicians; referral; specialization.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Guideline selection process. Abbreviations: AAAAI, American Academy of Allergy Asthma and Immunology; EPR-3, Expert Panel Report-3; GINA, Global Initiative for Asthma; ICON, International Consensus; IPCRG, International Primary Care Respiratory Group; NAEPP, National Asthma Education and Prevention Program; PRACTALL, Practical Allergy.
See this image and copyright information in PMC

References

    1. World Health Organization Chronic respiratory diseases; Scope: asthma. [Accessed January 18, 2017]. cited 2014. Available from: http://www.who.int/respiratory/asthma/scope/en/
    1. Bousquet J, Khaltaev N, editors. Global surveillance, prevention and control of chronic respiratory diseases: a comprehensive approach. World Health Organization; 2007. [Accessed January 18, 2017]. Available from: http://www.who.int/gard/publications/GARD%20Book%202007.pdf.
    1. Cottini M, Asero R. Asthma phenotypes today. Eur Ann Allergy Clin Immunol. 2013;45(1):17–24. - PubMed
    1. Lotvall J, Akdis CA, Bacharier LB, et al. Asthma endotypes: a new approach to classification of disease entities within the asthma syndrome. J Allergy Clin Immunol. 2011;127(2):355–360. - PubMed
    1. Global Initiative for Asthma Global Strategy for Asthma Management and Prevention. 2016. [Accessed January 18, 2017]. Available from: www.ginasthma.org.

LinkOut - more resources