Asthma

Asthma is a chronic lung disease and a major global public health issue. Asthma affects over 10% of people in Canada. Diagnosis is based on clinical history and lung function tests. With early diagnosis and appropriate personalized management, most people with asthma can live normal, health, active lives. About 5% of people with asthma have difficult-to-treat or severe asthma, which can interfere significantly with health and daily life. Our asthma team at CLH has the expertise to investigate and optimize asthma control in this challenging subgroup.

Research

We believe in the power of prevention to fundamentally reduce the root causes of this challenging airways disorder. This belief underlies our philosophy that physicians need be part of teams and initiatives that guide programs and policies to reduce primary risk factors for the development and progression of asthma. Accordingly, we have a large suite of projects that build our understanding of predisposing elements for asthma and explore how to moderate or remove them. Our faculty members who are affiliated with the UBC School of Population and Public Health bring that preventive lens to our interaction with patients and community. Our airways educator strongly incorporates preventive principles into her approach to care for all patients with asthma. Recognizing the importance of smoking cessation to asthma prevention management, we are also a sponsor of the local smoking cessation clinic.

CLH researchers have played prominent roles in the development of novel therapies for both severe and mild asthma, transforming how asthma is treated throughout the disease spectrum. Until relatively recently, there were no effective and safe treatments for severe asthma. With our greater understanding of the underlying inflammation and pathology of asthma, as well as human factors such as health literacy that impact asthma control, we have recognized the potential benefits of targeted therapy and personalized health care. Our group (led until recently by Dr. Mark FitzGerald) has had a leadership role in developing protocols for these new therapies. The success of our research program has transformed and expanded care options for people living with asthma.

Our site is the Canadian lead for the International Severe Asthma Registry (ISAR) and the Canadian Severe Asthma Registry (CSAR), with collaboration from nine other Canadian sites. Recruitment is ongoing (see links for more details), including within our Severe Asthma Clinic. Participation in the registry has been key to success in finding tools and methods to continually improve the care of people living with severe asthma, in our own clinic and beyond.

Furthermore, we strive to partner with patients to reach optimal asthma control through an ongoing research program on health literacy. Health literacy is the collection of skills needed to navigate and effectively use health information and care services, for asthma and beyond. It is influenced by personal attributes and capabilities, as well as the capacity of healthcare systems to facilitate access to and delivery of services. Our research explores ways to integrate health literacy considerations into a patient-centred model of respiratory health care that meets the needs of all chronic airway disease patients.

Through the Legacy for Airway Health initiative, we work with patients, clinicians, and other stakeholders as partners in research and health care improvement for asthma and other airways diseases.

Care

Clinical care for all levels of asthma severity is provided through the Centre for Lung Health, an outpatient UBC teaching and research clinic located in the Diamond Health Care Centre at Vancouver General Hospital.

Asthma management includes:

  • Confirmation of asthma diagnosis and severity
  • Review and optimization of comorbidities
  • Asthma assessment and phenotyping
  • Asthma education by a certified asthma educator
  • Home peak expiratory flow monitoring
  • Review of PharmaNet
  • Collaboration with allergists and ENT specialists as needed
  • Optimization of asthma management and therapy
  • Regular monitoring of asthma with Asthma Control Questionnaire, spirometry, and FeNO as needed

Additionally, for those referred with severe asthma, we offer:

  • Monthly Allergy Asthma Clinic where patients may be assessed in a single visit by an allergist, respirologist, and asthma educator
  • Monthly virtual multidisciplinary severe asthma rounds for discussion of challenging cases
  • Discussion and arrangement of biologic therapies as appropriate

Patients with asthma may choose to participate in research studies (see links below for details) through the Severe Asthma Registry, pharmaceutical trials of current or future asthma therapies, and a broad range of investigator-initiated research projects.

Research

We believe in the power of prevention to fundamentally reduce the root causes of this challenging airways disorder. This belief underlies our philosophy that physicians need be part of teams and initiatives that guide programs and policies to reduce primary risk factors for the development and progression of asthma. Accordingly, we have a large suite of projects that build our understanding of predisposing elements for asthma and explore how to moderate or remove them. Our faculty members who are affiliated with the UBC School of Population and Public Health bring that preventive lens to our interaction with patients and community. Our airways educator strongly incorporates preventive principles into her approach to care for all patients with asthma. Recognizing the importance of smoking cessation to asthma prevention management, we are also a sponsor of the local smoking cessation clinic.

CLH researchers have played prominent roles in the development of novel therapies for both severe and mild asthma, transforming how asthma is treated throughout the disease spectrum. Until relatively recently, there were no effective and safe treatments for severe asthma. With our greater understanding of the underlying inflammation and pathology of asthma, as well as human factors such as health literacy that impact asthma control, we have recognized the potential benefits of targeted therapy and personalized health care. Our group (led until recently by Dr. Mark FitzGerald) has had a leadership role in developing protocols for these new therapies. The success of our research program has transformed and expanded care options for people living with asthma.

Our site is the Canadian lead for the International Severe Asthma Registry (ISAR) and the Canadian Severe Asthma Registry (CSAR), with collaboration from nine other Canadian sites. Recruitment is ongoing (see links for more details), including within our Severe Asthma Clinic. Participation in the registry has been key to success in finding tools and methods to continually improve the care of people living with severe asthma, in our own clinic and beyond.

Furthermore, we strive to partner with patients to reach optimal asthma control through an ongoing research program on health literacy. Health literacy is the collection of skills needed to navigate and effectively use health information and care services, for asthma and beyond. It is influenced by personal attributes and capabilities, as well as the capacity of healthcare systems to facilitate access to and delivery of services. Our research explores ways to integrate health literacy considerations into a patient-centred model of respiratory health care that meets the needs of all chronic airway disease patients.

Through the Legacy for Airway Health initiative, we work with patients, clinicians, and other stakeholders as partners in research and health care improvement for asthma and other airways diseases.

Care

Clinical care for all levels of asthma severity is provided through the Centre for Lung Health, an outpatient UBC teaching and research clinic located in the Diamond Health Care Centre at Vancouver General Hospital.

Asthma management includes:

  • Confirmation of asthma diagnosis and severity
  • Review and optimization of comorbidities
  • Asthma assessment and phenotyping
  • Asthma education by a certified asthma educator
  • Home peak expiratory flow monitoring
  • Review of PharmaNet
  • Collaboration with allergists and ENT specialists as needed
  • Optimization of asthma management and therapy
  • Regular monitoring of asthma with Asthma Control Questionnaire, spirometry, and FeNO as needed

Additionally, for those referred with severe asthma, we offer:

  • Monthly Allergy Asthma Clinic where patients may be assessed in a single visit by an allergist, respirologist, and asthma educator
  • Monthly virtual multidisciplinary severe asthma rounds for discussion of challenging cases
  • Discussion and arrangement of biologic therapies as appropriate

Patients with asthma may choose to participate in research studies (see links below for details) through the Severe Asthma Registry, pharmaceutical trials of current or future asthma therapies, and a broad range of investigator-initiated research projects.

People

Selected Publications

  • Real World Biologic Use and Switch Patterns in Severe Asthma: Data from the International Severe Asthma Registry and the US CHRONICLE Study. Menzies-Gow, AN et al. Journal of Asthma and Allergy 2022;15:63-78. https://doi.org/10.2147/JAA.S328653
  • Cluster Analysis of Inflammatory Biomarker Expression in the International Severe Asthma Registry. Denton, E et al. Journal of Allergy and Clinical Immunology: In Practice 2021;9:2680-8. https://doi.org/10.1016/j.jaip.2021.02.059