May 2, 2023 – This World Asthma Day, on behalf of the 3.8 million people living with asthma in Canada, Asthma Canada is calling on policy makers and health system leaders to ensure Canadians have access to high-quality respiratory care, when and where they need it. With health systems across the country experiencing challenges, Canadians are struggling to access respiratory care, impacting their ability to control their symptoms, adding more pressure on an already strained acute care system. A recent study Asthma Canada participated in shows high consensus for Canadians living with asthma and severe asthma to have access to specialist care within the optimal period of 4-8 weeks.

“Amanda was healthy, outgoing, worked out every day, and never missed a walk with her dog, Scout and son, Ethan,” said Gary Staples, Amanda’s partner and a paramedic in Ontario. It was during one of those walks that Gary received a message from Amanda that he would never forget, “I can’t breathe!”. Amanda sadly passed away from an asthma attack that day. “While Amanda was waiting for her in-person specialist appointment, she used her inhalers more frequently than we knew, yet she was still having issues controlling her asthma. Unfortunately, she never made it to that specialist appointment. The day after we lost her, in her mailbox was the appointment letter dated for two months from then.”

Amanda’s story illustrates the need to address the factors that lead to many Canadians living with uncontrolled asthma, including long wait times to access specialist care and over-reliance on short-acting beta-agonist (SABA) inhalers.

Asthma Canada was a participant in an expert steering committee that developed the first Canadian stakeholder consensus for diagnosis, appropriate referral, and treatment of severe asthma. More than 150 certified respiratory educators, respirologists, allergists, general practitioners/family physicians, nurses, pharmacists, and respiratory therapists from across the country participated in the study, to lay out a path for high-quality respiratory care for Canadians.

“The study presents policy makers with a road map and best practices to improve the quality of care, resulting in improved outcomes, quality of life and patient experience for Canadians living with severe asthma and their caregivers,” said Jeff Beach, President and CEO, Asthma Canada. “The cost of asthma to the Canadian economy is expected to climb to $4.2 billion annually by 2030. We need concerted action to ensure all Canadians living with asthma have access to the quality and timely care they need.”

Recommendations include:

  1. Address the gaps in timely and accurate referrals to specialists, complying with the 4–8-week optimal period, for patients living with asthma.
  2. Explore an enhanced role for pharmacists in helping identify asthma patients who have an over-reliance on SABA inhalers, a sign that their asthma is uncontrolled.
  3. Explore an enhanced role for allied health care professionals, such as certified respiratory educators, who can support the care system.

“With the current capacity pressures on our health system, we see a clear opportunity for allied health professionals, such as certified respiratory educators, to play an increased role in improving asthma management for patients,” said Dr. Susan Waserman, Professor and Director, Division of Clinical Immunology & Allergy, Schroeder Chair in Allergy and Immunology Research, McMaster University and Chair of Asthma Canada’s Medical and Scientific Advisory Committee. “Many people face challenges in accessing primary and specialist care, and certified respiratory educators can help fill this gap in the care continuum, helping patients better manage their asthma, preventing premature deaths and avoiding exacerbations and visits to the emergency room.”

For nearly 50 years, Asthma Canada has proudly served as the national voice for Canadians living with asthma. This World Asthma Canada Day we are calling on policy makers to make asthma care a priority and act on the recommendations for high-quality care in the consensus statements study.              

About the Study

The steering group of asthma experts from across the country, met in 2022 to systematically identify key topics in the severe asthma care pathway through existing guidance and practice in Canada. This culminated in the creation of 43 consensus statements for testing, then used to develop a Likert questionnaire, which was sent out to health care providers including pulmonologists, allergists, family doctors, nurses, pharmacists, certified respiratory educators, and respiratory therapists.

Respondents were offered a 4-point scale to rate their agreement with each statement, ranging across ‘strongly disagree’, ‘tend to disagree’, ‘tend to agree’ and ‘strongly agree’. Completed questionnaires were collated and the individual scores for each statement analyzed to produce an arithmetic agreement score for each.

The responses to consensus statements were analyzed in line with Delphi methodology (a forecasting process and structured communication framework based on the results of multiple rounds of questionnaires sent to a panel of experts). The steering group predefined agreement for consensus at 75%, a widely accepted threshold. Consensus was defined as ‘high’ at≥75% and ‘very high’ at≥90%.

About Asthma Canada

Asthma Canada is the only national, patient-driven charitable organization solely devoted to enhancing the quality of life for people living with asthma and respiratory allergies. For nearly 50 years, Asthma Canada has proudly served as the national voice for Canadians living with asthma, empowering patients with evidence-based information, education programs and supporting asthma research in Canada. Learn more at www.asthma.ca

Contact: Jharna Bajaj, jharna.bajaj@hkstrategies.ca, 647 807 7570