title: How to set up a severe asthma service.
abstract: Severe asthma affects 5-20% of the asthma population but is discordantly responsible for the major burden of illness and impairment to quality of life. Patients with severe asthma continue to experience ongoing symptoms despite maximal therapy. A severe asthma service provides a systematic approach to the management of the disease and aids in confirming the correct diagnosis, managing comorbid conditions that may mimic or aggravate asthma, and provides the environment to optimize treatment and asthma self-management skills and education. A severe asthma service is also the ideal environment for trialling add-on therapies and hence can improve patient outcomes and clinical practice. Within such a service there are many opportunities for training and research. In this article we describe the purpose of a severe asthma clinic, the necessary components of a service including staffing and facilities and the processes for trialling additional therapies used in the management of severe asthma.
authors.affiliation: Department of Respiratory and Sleep Medicine, Hunter Medical Research Institute, The University of Newcastle, New South Wales, Australia.
authors.forename: Vanessa M
authors.initials: VM
authors.lastname: McDonald
authors.forename: Anne E
authors.initials: AE
authors.lastname: Vertigan
authors.forename: Peter G
authors.initials: PG
authors.lastname: Gibson
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000318:Adrenergic beta-Agonists / Q000009:adverse effects / Q000627:therapeutic use; D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D000888:Antibodies, Anti-Idiotypic / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017964:Itraconazole / Q000627:therapeutic use; D020024:Leukotriene Antagonists / Q000627:therapeutic use; D018942:Macrolides / Q000627:therapeutic use; D009330:Nebulizers and Vaporizers; D000069444:Omalizumab; D012720:Severity of Illness Index; D000078329:Workforce
chemical_list: D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D018927:Anti-Asthmatic Agents; D000888:Antibodies, Anti-Idiotypic; D061067:Antibodies, Monoclonal, Humanized; D001993:Bronchodilator Agents; D007166:Immunosuppressive Agents; D020024:Leukotriene Antagonists; D018942:Macrolides; D000069444:Omalizumab; D017964:Itraconazole