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Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma

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Published on: November 4, 2010

Subspecialty differences in asthma characteristics and management.

Hubert Chen¹, Charles A Johnson, Tmirah Haselkorn

¹Division of Pulmonary and Critical Care Medicine, University of California San Francisco, CA, USA. hubert.chen@ucsf.edu

Mayo Clinic Proceedings

|July 11, 2008

Summary

Asthma patients seeing pulmonologists generally have more severe disease, lower socioeconomic status, and higher healthcare use compared to those treated by allergists. Allergists are more likely to perform allergy testing and immunotherapy.

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Area of Science:

Pulmonology
Allergy and Immunology
Epidemiology

Background:

Asthma management and patient characteristics can vary based on physician subspecialty.
Understanding these differences is crucial for optimizing asthma care across different patient populations.
The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) study provides valuable data on asthma patients.

Purpose of the Study:

To investigate and quantify the differences in asthma characteristics and management between allergy and pulmonary subspecialists.
To identify patient demographics, disease severity, and treatment patterns associated with each subspecialty.

Main Methods:

Utilized baseline data from 3342 adult participants in the multicenter, observational TENOR study.
Collected information on physician subspecialty, asthma history, allergic status, lung function, medication use, and healthcare utilization.
Employed study coordinator-administered interviews and validated self-administered questionnaires.

Main Results:

Patients treated by pulmonologists (28%) were more likely to be Black, less educated, and have lower incomes than those treated by allergists (72%).
Pulmonologist-treated patients exhibited more severe asthma, indicated by physician assessment, Global Initiative for Asthma classification, lung function, and control problems.
Pulmonologist-treated patients used short-acting beta-agonists and systemic corticosteroids more frequently and reported higher healthcare use, despite similar allergic disease prevalence.

Conclusions:

Asthma patients managed by pulmonologists generally present with lower socioeconomic status and more severe disease.
These patients require more medication and utilize healthcare services more frequently compared to those seen by allergists.
Allergist-treated patients were more likely to undergo skin testing or immunotherapy, suggesting a targeted approach to allergic components of asthma.