Table 4.
Suggestions for Overcoming the Barriers to Effective Management of Severe Asthma
| Target Audience | Suggestions |
|---|---|
| Pulmonary/allergy centers with the authority to prescribe biologic drugs | Creating dedicated agendas and preferential channels for patients with severe asthma |
| Establishing a diagnostic-therapeutic pathway for severe asthma | |
| Conducting interdisciplinary internal meetings (otolaryngologist, psychologists, gastroenterologists, interventionists) | |
| Keeping clinical registries to support the network among centers | |
| Pulmonologists/allergists without the authority to prescribe biologic drugs | Establishing collaboration between GPs/specialists who can prescribe biologic agents and specialists who cannot prescribe biologic agents |
| Conducting regular training on referral criteria | |
| Conducting training to become a prescribing center | |
| Collaborating with specialists who treat comorbidities | |
| Patients and caregivers | Improving public awareness of severe asthma |
| Education about severe asthma in schools | |
| Supporting patients’ associations | |
| Providing support for scientific societies | |
| GPs | Conducting refresher courses on severe asthma |
| Creating a network with specialist centers | |
| Providing GPs with objective parameters for recognizing severe asthma (flow charts, alerts for indicators of uncontrolled asthma) | |
| Training in spirometry and diagnostic techniques | |
| Emergency units | Improving identification of patients with severe asthma and facilitating their referral to appropriate specialists |
| Improving training on how to recognize severe asthma | |
| Promoting collaboration within hospitals | |
| Promoting collaboration between first aid providers and biologic prescribing centers | |
| Hospital pharmacists | Increasing the involvement of hospital pharmacists in the management of severe asthma |
| Taking advantage of big data available to pharmacists (eg about over-prescription of OCS) | |
| Conducting video tutorials in pharmacies | |
| Providing spirometry assessments in hospital pharmacies | |
| Payers | Establishing outpatient clinics dedicated to asthma |
| Implementing Integrated Care Pathways | |
| Collection of Italian epidemiological data and conducting pharmacoeconomic analyses on the use of biologics | |
| Establishing regional networks | |
| All target audiences | Creating a hub-and-spoke/collaborative network |
| Providing preferential channels for specialist visits for patients with severe asthma | |
| Creating a network connecting all stakeholders at the regional level | |
| Imitating existing local best practices |
Abbreviations: GP, general practitioner; OCS, oral corticosteroids.