Among Americans with severe asthma, a condition that disproportionately affects Blacks, less than half see a specialist to manage their condition, research shows.
Only 38 percent of severe asthma patients saw an allergist/immunologist or a pulmonologist at least once in the year before or after the first observation of severe asthma, the investigators found.
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Why you should see an asthma specialist
The U.S. National Heart, Lung, and Blood Institute recommends patients with severe asthma be referred to a specialist for evaluation and care.
“Specialist care is important for managing any condition, especially a chronic one such as severe asthma,” lead author Dr. Jessica Most, a pulmonologist at Jefferson Health/National Jewish Health, in Philadelphia says.
After a specialist visit, asthma attacks were much lower (about 38 percent versus 49 percent). Hospitalizations, emergency department visits and use of rescue inhalers also were lower for patients during the 12 months after their first visit to a specialist, the study found.
The greatest predictors for a specialist visit were higher numbers of asthma attacks, younger age, and having severe asthma identified in a recent year.
The benefits of seeing an asthma specialist include:
- They can provide the latest asthma research
- They can provide the latest asthma medications and help you understand their use
- They are up to date on the standards and advances in asthma care
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When do you need an asthma specialist?
While a mild case with obvious triggers that responds well to medication may not require a visit to a specialist, you should consider a specialist if you are experiencing the following:
- A life-threatening asthma attack, intubation, or admission to a hospital or intensive care unit for asthma
- Poorly controlled asthma despite three to six months of consistent treatment
- Are interested in allergy shots to help control asthma triggered by allergens
- Worsening asthma despite using oral steroids
- Moderate persistent or more severe asthma
- Need asthma education
You may also be referred to an asthma specialist by your primary care physician if you:
- Need more diagnostic testing such as a challenge test, skin test, or lung function test
- Have asthma symptoms or responses to treatment that aren’t typical
- May have cough-variant asthma, occupational asthma, nocturnal asthma, or exercise-induced asthma
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Types of asthma specialists
1. Pulmonologist
Pulmonologists specialize in preventing, diagnosing, and treating lung and respiratory illnesses for several conditions. These conditions include:
- asthma
- bronchitis
- chronic obstructive pulmonary disease (COPD)
- obstructive sleep apnea
- lung cancer
A pediatric pulmonologist specializes in breathing problems in children until they are 21 for the following conditions:
- chronic cough
- cystic fibrosis
- lung disease in premature babies
What can they do for you?
Pulmonologists can give you a broader understanding of not only asthma and your lungs, but the impact of asthma and respiratory diseases.
Essentially, they can:
- Help you manage asthma alongside other health conditions
- Identify exacerbating factors such as sleep apnea or GERD
- Provide a more in-depth diagnosis of your asthma (e.g., is it nocturnal as well as exercise-induced)
- Confirm (or rule out) a difficult diagnosis
- Evaluate the success of your treatment regimen
- Track your progress
If your asthma is a result of allergies, a pulmonologist may not be the best choice for you.
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2. Allergist/Immunologist
An allergist/immunologist manages allergies, asthma, and diseases of the immune system. An allergist/immunologist manages seasonal environmental, drug, and food allergies, as well as allergy-related skin conditions. They can also treat severe allergic reactions.
What can they do for you?
An allergist/immunologist can help you understand the complicated process that can lead to allergies and asthma attacks.
Essentially, they can:
- Identify whether your asthma is allergy-induced
- Identify what you’re allergic to
- Treat both your allergies and your asthma
- Help you learn how to avoid allergens
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3. Respiratory Therapist/Pulmonary Rehab Specialist
Respiratory therapists are not technically doctors. They are healthcare providers specially trained to treat asthma through lung exercises.
What can they do for you?
Respiratory therapists are not a replacement for primary healthcare providers because they can’t prescribe asthma medications. However, they are a great addition to your primary healthcare providers if you find yourself short of breath and/or want to exercise more.
A respiratory therapist can:
- Assess your asthma and lung function
- Teach you breathing exercises that help restore the normal function of your lungs
- Teach you to properly use an inhaler
- Work with healthcare providers to determine treatments
PR specialists can:
- Provide significant education on how to live with asthma
- Help you understand your treatment regimen
- Identify any risk factors that may exacerbate your condition
- Suggest beneficial nutritional changes and other lifestyle modifications
- Design and monitor an exercise regimen for you (beyond lung exercises)
Research published in 2020 also shows that pulmonary rehabilitation is beneficial for people with any stage of asthma because it can:
- Improve exercise capacity
- Lead to better asthma control
- Improve quality of life
- Reduce wheezing and bronchial inflammation
- Improve anxiety and depression
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Finding a specialist
If you have insurance, check to see who is in your network and ask your PCP about a referral. You can also utilize online reviews and directories, such as the American College of Allergy, Asthma and Immunology, which can help you find an asthma specialist/allergist. The best way to find the appropriate specialist is to create a list and gather several names in case you run into long wait times or specialists that don’t cover your insurance or aren’t accepting new patients.
Once you find a specialist, remember to bring any relevant medical records, including test results and medication lists to your first appointment. Remember that your first appointment can be a trial run to make sure that the specialist is the right fit for you and has the level of expertise you need to get the appropriate care.
Although asthma isn’t curable, finding the right specialist can help you manage your asthma symptoms, reduce the severity of your asthma and reduce the number of flare-ups you experience.
