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Less Than Half of U.S. Patients With Severe Asthma Seek Care From a Specialist

AAAAI News Release

June 17, 2021

April Presnell
(414) 272-6071

Specialist care can improve patient outcomes according to research published in The Journal of Allergy and Clinical Immunology: In Practice (JACI: In Practice), an official journal of the AAAAI.

Milwaukee, WI - Specialist care was reported in less than half of U.S. patients with severe asthma, and was the least frequent among populations of older adult patients and those with non-respiratory comorbidities. These results come from a new study published in The Journal of Allergy and Clinical Immunology: In Practice (JACI: In Practice), an official journal of the American Academy of Allergy, Asthma & Immunology (AAAAI).

The 2007 guidelines of the U.S. National Heart, Lung, and Blood Institute recommend patients with severe asthma are referred to a specialist for both assessment and co-management. In an effort to determine how many patients do see specialists for their severe asthma, researchers identified patients with severe asthma who were 6 years of age and older between January 1, 2015, and December 31, 2017, using the IQVIA PharMetrics® Plus database of commercially-insured individuals.

A total of 54,332 patients were identified. Of those, 38.2% saw an allergist/immunologist or a pulmonologist at least once in the 12 months before or after the first observation of severe asthma. A subgroup analysis of 5,988 patients evaluated outcomes before and after a specialist visit, and found controller medication fills and biologic medication prescriptions were higher for patients seeing a specialist. Asthma exacerbations were also significantly lower (37.7% versus 49.4%) following a specialist visit. Hospitalizations and emergency department visits, as well as rescue inhaler use, were also lower for patients who saw a specialist during the 12 months after the first specialist visit.

“Our findings suggest that specialist visits for severe asthma are very underutilized, with only four in 10 patients seeking care over a 2-year period,” said the leading author, Jessica F. Most, MD. “Specialist care is important for managing any condition, especially a chronic one such as severe asthma. Efforts should be made to increase specialist referrals, especially among populations who are less likely to seek out care from an allergist/immunologist or pulmonologist.”  

Analysis showed that the greatest predictors of having an asthma specialist visit were higher numbers of asthma exacerbations, younger age, and having severe asthma identified in a more recent year. Patients with non-respiratory comorbidities, those 65 and older, and male patients were less likely to seek specialist care.

You can learn more about asthma on the American Academy of Allergy, Asthma & Immunology website,

The American Academy of Allergy, Asthma & Immunology (AAAAI) represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI has more than 7,100 members in the United States, Canada and 72 other countries. The AAAAI’s Find an Allergist/Immunologist service is a trusted resource to help you find a specialist close to home.