The following is a summary of “A survey of severe asthma in Canada: results from the CASCADE practice reflective program,” published in the 18 April 2024 issue of Allergy & Immunology by Godbout, et al.

The Canadian Thoracic Society’s last guidance on severe asthma has been followed by significant advancements in clinical management. The CASCADE practice reflective program was launched to understand the current standards of care and treatment patterns. For a study, researchers sought to analyze real-world severe asthma management among Canadian specialists, identifying opportunities to enhance patient outcomes.

The CASCADE program consisted of a two-part practice reflective and assessment initiative delivered online to selected specialists (Respirologists and Allergists) in Canada. Initially, a one-time overview survey established general practice parameters. Subsequently, specialists reviewed five patients with severe asthma to evaluate the current management landscape.

The program included 78 specialists (52 Respirologists, 24 Allergists, and 2 General practice physicians focusing on respiratory disease) from eight provinces, covering diverse practice settings from large metropolitan centers to smaller regional areas. A total of 503 patients were reviewed. Of these, 65% were biologic treatments, 30% were biologic-naive, and 5% had previously used biologics. Although physicians perceived an even distribution of allergic, eosinophilic, and mixed phenotypes, 53% of patients reported having mixed allergic and eosinophilic phenotypes. Patients on biologic treatments generally exhibited higher control and greater satisfaction with their treatment. However, less than optimal satisfaction was noted in over half of all patients, especially those not on biologic agents.

Limited availability for certain assessments challenges phenotyping, and the full range of treatments is underutilized due to physician familiarity and prescribing restrictions. Even with biological treatments, patient satisfaction remained an area for improvement, indicating a need for enhanced management strategies in severe asthma care.

Reference: aacijournal.biomedcentral.com/articles/10.1186/s13223-024-00891-x