Engaging The Patient Who has Moderate-To-Severe Asthma Module 3

Michael E. Wechsler, MD, MMSc; Barbara P. Yawn, MD, MSc, FAAFP

This activity is jointly provided by Global Education Group and Integritas Communications.


This activity is supported by an independent educational grant from Sanofi Genzyme and Regeneron Pharmaceuticals.


Michael E. Wechsler, MD, MMSc
Professor, Department of Medicine
Co-Director, The Cohen Family Asthma Institute
Division of Pulmonary, Critical Care and Sleep Medicine
Director, Asthma Program
National Jewish Health
Denver, Colorado

Barbara P. Yawn, MD, MSc, FAAFP
Adjunct Professor
Department of Family and Community Health
University of Minnesota
Minneapolis, Minnesota

Target Audience

The educational design of this activity addresses the needs of primary care providers (PCPs) and other clinicians involved in the ongoing management of patients with moderate-to-severe asthma.

Educational Objectives

Upon completion of this activity, participants will be better able to do the following:

  • Engage patients with moderate-to-severe asthma to promote disease education, self-advocacy, and shared decision-making

Statement of Need/Program Overview

Asthma is a chronic respiratory disease characterized by a range of symptoms, including variable expiratory airflow limitations, wheezing, shortness of breath, chest tightness, and/or cough1. Asthma-related symptoms and exacerbations result in almost 2 million emergency department visits each year, which often lead to inpatient hospital stays [2, 3]. Importantly, studies have shown that severe disease accounts for an outsized proportion of asthma-related morbidity, mortality, and health care costs 4-8. Studies have demonstrated that patients who have severe or difficult-to-treat asthma are markedly impaired by their disease despite increased use of health care services and common prescription of multiple medications 8,9. In primary care practices, identification of patients with severe asthma is often confounded by the documented tendencies of both clinicians and patients to underestimate the prevalence of asthma symptoms and to overestimate the degree to which the disease is controlled9-12. In fact, there is evidence that most patients with asthma managed in general family practices are not adequately controlled10. When severe asthma remains uncontrolled, patients are at increased risk for death, have lower lung function, suffer from worse health-related quality of life, and are more likely to miss work or school 4,13-15. Moreover, the personal and societal costs of asthma increase with the number of factors that indicate that the disease is poorly controlled 13,15. In this 4-part CME Snapshot series, expert faculty will convey the urgency of identifying cases of severe and uncontrolled asthma in primary care; highlight the importance of collaborative care, especially in patients for whom biologic therapy can help reduce morbidity, mortality, and resource utilization; and advise on educating patients on their disease state and treatment options. After completion, learners will be well-equipped to translate the latest information on treatment options and perspectives on asthma management into next-day practice.


  1. Chung KF, et al. International ERS/ATS guidelines on definition, evaluation and treatment of severe asthma. Eur Respir J. 2014;43(2):343-373.
  2. Centers for Disease Control and Prevention (CDC). Asthma Facts: CDC’s National Asthma Control Program Grantees. 2013.
  3. Nunes C, et al. Asthma costs and social impact. Asthma Res Pract. 2017;3:1.
  4. Levy ML. The national review of asthma deaths: what did we learn and what needs to change? Breathe (Sheff). 2015;11(1):14-24.
  5. Bahadori K, et al. Economic burden of asthma: a systematic review. BMC Pulm Med. 2009;9:24.
  6. Eassey D, et al. "…I've said I wish I was dead, you'd be better off without me": A systematic review of people's experiences of living with severe asthma. J Asthma. 2019;56(3):311-322.
  7. Chipps BE, et al. Key findings and clinical implications from The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) study. J Allergy Clin Immunol. 2012;130(2):332-342.
  8. Chipps BE, et al. More than a decade follow-up in patients with severe or difficult-to-treat asthma: The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) II. J Allergy Clin Immunol. 2018;141(5):1590-1597.
  9. Wechsler ME. Managing asthma in primary care: putting new guideline recommendations into context. Mayo Clin Proc. 2009;84(8):707-717.
  10. Chapman KR, et al. Suboptimal asthma control: prevalence, detection and consequences in general practice. Eur Respir J. 2008;31(2):320-325.
  11. Horne R, et al. Can asthma control be improved by understanding the patient's perspective? BMC Pulm Med. 2007;7:8.
  12. Haughney J, et al. Achieving asthma control in practice: understanding the reasons for poor control. Respir Med. 2008;102(12):1681-1693.
  13. Sullivan SD, et al. Extent, patterns, and burden of uncontrolled disease in severe or difficult-to-treat asthma. Allergy. 2007;62(2):126-133.
  14. Strine TW, et al. Risk behaviors and health-related quality of life among adults with asthma: the role of mental health status. Chest. 2004;126(6):1849-1854.
  15. Hiles SA, et al. Working while unwell: workplace impairment in people with severe asthma. Clin Exp Allergy. 2018;48(6)650-662.

Physician Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Global Education Group (Global) and Integritas Communications. Global is accredited by the ACCME to provide continuing medical education for physicians.

Physician Credit Designation

Global Education Group designates this enduring activity for a maximum of 0.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurse Practitioner Continuing Education

This activity has been planned and implemented in accordance with the Accreditation Standards of the American Association of Nurse Practitioners (AANP) through the joint providership of Global and Integritas Communications. Global is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number: 110121. This activity is approved for 0.25 contact hour(s) (which includes 0.0 hour(s) of pharmacology).

Instructions to Recieve Credit

In order to receive credit for this activity, the participant must score 70% or better on the posttest and complete the program evaluation.

System Requirements

Microsoft Windows 2000 SE or above.
Flash Player Plugin (v7.0.1.9 or greater)
Internet Explorer (v5.5 or greater), or Firefox
Adobe Acrobat Reader*

MAC OS 10.2.8
Flash Player Plugin (v7.0.1.9 or greater)
Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh.

Fee Information & Refund/Cancellation Policy

There is no fee for this educational activity.

Disclosure of Conflicts of Interest

Global Education Group (Global) requires instructors, planners, managers, and other individuals and their spouses/life partners who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by Global for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Michael E. Wechsler, MD, MMSc: Consultant/Advisor: AstraZeneca plc, Cohero Health, Inc., Equillium, Inc., Genentech, Inc., GlaxoSmithKline plc, Novartis Pharmaceutical Corporation, Regeneron Pharmaceuticals, Inc., resTORbio, Inc., sanofi-aventis U.S. LLC, Teva Pharmaceutical Industries, Ltd. Grant/Research: Grant/Research: AstraZeneca plc; Regeneron Pharmaceuticals, Inc., sanofi-aventis U.S. LLC, Teva Pharmaceutical Industries, Ltd.

Barbara Yawn, MD, MSc, FAAFP: Consultant/Independent Contractor: AstraZeneca plc, Boehringer Ingelheim International GmbH, GlaxoSmithKline plc

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouses/life partners have with commercial interests related to the content of this CME activity:

Kristin Delisi, NP: Nothing to disclose
Lindsay Borvansky: Nothing to disclose
Andrea Funk: Nothing to disclose
Liddy Knight: Nothing to disclose
Ashley Cann: Nothing to disclose
Julia Mulino: Nothing to disclose
Rose O’Connor, PhD, CHCP: Nothing to disclose

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration. Global Education Group (Global) and Integritas Communications do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Global Contact Information

For information about the accreditation of this program, please contact Global at 303-395-1782 or

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credit amount 0.25

credit type CME/AANP

release 08/27/2020

expiration 08/27/2021

type SnapShot