
Caring for Patients with Severe Asthma
Evolving Best Practices to Optimize Outcomes
Clinical Practice Guidelines
Global Strategy for Asthma Management and Prevention
Global Initiative for Asthma (GINA) 2017.
International ERS/ATS Guidelines on Definition, Evaluation and Treatment of Severe Asthma
Chung KF, et al. Eur Respir J. 2014;43(2):343-373.
Patient Resources
Asthma and Allergy Foundation of America (AAFA)
AAFA is dedicated to improving the quality of life for people with asthma and allergic diseases through education, advocacy, and research.
American College of Allergy, Asthma & Immunology (ACAAI)
The ACAAI fosters a culture of collaboration and congeniality in which members work toward the common goals of patient care, education, advocacy, and research.
American College of Physicians (ACP)
The ACP provides a number of resources for patients with asthma, including instructional videos about how to use different types of inhalers.
American Lung Association
The American Lung Association is the leading organization working to save lives by improving lung health and preventing lung disease through education, advocacy, and research.
American Thoracic Society (ATS)
The mission of the ATS is to improve health worldwide by advancing research, clinical care, and public health in respiratory disease, critical illness, and sleep disorders.
Asthma Action Plan
This printable reference tool is designed to help patients know when to use their different asthma medications and when to call their health care providers.
Asthma and Outdoor Air Pollution
This resource provides guidance to patients who are sensitive to air pollution.
Asthma Inhalers
This is a list of different inhaled asthma medications with key information such as prescribing information and tips for proper inhaler technique.
How to Use a Metered-Dose Inhaler
Printed instructions and short videos are provided to aid patients in taking their medication correctly.
My Asthma Wallet Card
This printable card for patients to carry lists important information, such as current medications and health care provider contact information.
Clinical Assessment Tools
Asthma Control Test (ACT)
This 5-question test evaluates asthma control over the past 4 weeks on a 5-point Likert scale. A score of <20 on the ACT suggests asthma that is uncontrolled. Nathan RA, et al. J Allergy Clin Immunol. 2004;113(1):59-65.
Asthma Control Questionnaire (ACQ)
This 7-question assessment tool measures asthma control over the past 7 days. Six questions are self-administered by the patient, and 1 question requires a clinician’s input. Scores range from 1 (totally controlled) to 6 (severely uncontrolled). Juniper EF, et al. Eur Respir J. 1999;14(4):902-907.
Asthma Therapy Assessment Questionnaire (ATAQ)
This 4-question test assesses asthma control over the past 4 weeks. Each question has a possible score of 0 or 1; if the sum of the 4 question scores is >1, the patient’s asthma may be uncontrolled. Vollmer WM, et al. Am J Crit Care Med. 1999;160(5 Pt 1):1647-1652.
Asthma APGAR Tool
This 6-question assessment tool evaluates asthma control over the past 2 weeks. Any combination with a total score >2 is considered not well controlled. Yawn BP, et al. J Asthma Allergy. 2008;1:1-10.
Suggested Readings
Efficacy and safety of tralokinumab in patients with severe uncontrolled asthma: a randomised,double-blind, placebo-controlled, phase 2b trial.
Brightling CE, et al. Lancet Respir Med. 2015;3(9):692-701.
Efficacy and safety of benralizumab for patients with severe asthma uncontrolled with high-dosage inhaled corticosteroids and long-acting β2-agonists (SIROCCO): a randomised, multicentre, placebo-controlled phase 3 trial.
Bleecker ER, et al. Lancet. 2016;388(10056):2115-2127.
Reslizumab for inadequately controlled asthma with elevated blood eosinophil counts: results from two multicentre, parallel, double-blind, randomised, placebo-controlled, phase 3 trials.
Castro M, et al. Lancet Respir Med. 2015;3(5):355-366.
A review of anti-IgE monoclonal antibody (omalizumab) as add on therapy for severe allergic (IgE-mediated) asthma.
D’Amato G, et al. Ther Clin Risk Manag. 2007;3(4):613-619.
Biologics in asthma—the next step towards personalized treatment.
Darveaux J, Busse WW. J Allergy Clin Immunol Pract. 2015;3(2):152-161.
Cluster analysis and clinical asthma phenotypes
Haldar P, et al. Am J Respir Crit Care Med. 2008;178:218-224.
Targeting key proximal drivers of type 2 inflammation in disease.
Gandhi NA, et al. Nat Rev Drug Discov. 2016;15(1):35-50
Benralizumab, an anti-interleukin-5 receptor α monoclonal antibody, as add-on treatment for patients with severe, uncontrolled, eosinophilic asthma (CALIMA): a randomised, double-blind, placebo-controlled phase 3 trial.
FitzGerald JM, et al. Lancet. 2016;388(10056):2128-2141.
Adult asthma biomarkers
Kim MA, et al. Curr Opin Allergy Clin Immunol. 2014;14(1):49-54.
Mepolizumab treatment in patients with severe eosinophilic asthma.
Ortega HG, et al. N Engl J Med. 2014;371(13):1198-1207.
Getting control of uncontrolled asthma
Wechsler ME. Am J Med. 2014;127(11):1049-1059.
Dupilumab efficacy and safety in adults with uncontrolled persistent asthma despite use of medium-to-high-dose inhaled corticosteroids plus a long-acting β2 agonist: a randomised double-blind placebo-controlled pivotal phase 2b dose-ranging trial.
Wenzel S, et al. Lancet. 2016;388(10039):31-44

Clinical Insights Into Severe Asthma Pathophysiology
Michael Wechsler, MD, MMSc
Caring for Patients with Severe Asthma Teaser
Eugene R. Bleecker, MD; Sidney S. Braman, MD, FCCP; Richard J. Martin, MD
Severe Asthma and the Primary Care Provider Teaser
Michael E. Wechsler, MD, MMSc; Barbara P. Yawn, MD, MSc, FAAFP
Evolving Best Practices to Optimize Outcomes
Improving Patient Outcomes via Coordinated Multidisciplinary Care
Relevant Resources
Overcoming Pain and Gastrointestinal Distress to Improve Patient Outcomes
Evidence-Based Strategies for Improved Patient Outcomes
Proactive Diagnosis and Targeted Management
Differential Diagnosis and Comprehensive Management Strategies
Optimizing Maintenance Therapy Across Healthcare Settings
Evolving Strategies for Diagnosis and Long-Term Management
Consensus and Controversies for Responsible Opioid Prescribing
Best Practices in Combination Therapy
Evolving Approaches to Insulin Based Therapy
Improving Outcomes for Patients with COPD
New Strategies for Insulin Replacement Therapy
Clinical Updates in LDL-C Management
Improving Comprehensive Patient Care
Identifying Patients and Tailoring Therapy
Collaborative Approaches to Guideline-Concordant Patient Care
New Strategies for Individualizing Long-term Care
A Focus on Patients With Opioid-Induced Constipation
Consensus and Controversies Across the Spectrum of Patient Presentations
A New Era in Precision Medicine
Evolving Treatment Algorithms and Expert Perspectives on Biosimilars
Consensus and Controversies on the Road to Precision Medicine
Ongoing Monitoring, Pulmonary Rehabilitation, and Individualized Care
The PCP’s Role in Timely Recognition and Referral
Debates and Discussions About Personalizing Patient Management
Differential Diagnosis, Multidisciplinary Management, and Patient Engagement
Key Issues Impacting OB/GYN Practice
From Guideline Recommendations to Daily Clinical Decision-Making
Improving Patient Outcomes Through Shared Clinical Decision Making
Volume II: Expanding Evidence for the Role of Rapid ART Initiation in HIV Practice
Improving Patient Outcomes Through Shared Clinical Decision Making
Digging Deep on Shared Decision-Making
Mechanistic Insights and Evolving Treatment Options
Clinical Resource Center
A Case-Based Conversation on Managing Asthma and Chronic Rhinosinusitis With Nasal Polyposis
The Clinical and Utilization Benefits of Exacerbation Prevention
Mechanistic Insights and Emerging Treatment Options
A PrEP Primer
A Foundation for Managed Care
A Focus on Exacerbation Prevention
Cardiovascular and Renal Outcomes With SGLT2 Inhibitors
Best Practices for Primary Care
New Paths to Chronic Pain Management
What the Pharmacist Needs to Know about PrEP
Unlocking Novel Paths to Patient Care
Evolving Best Practices for Patient Management