The Multi-Disciplinary Team Approach to Specialist Adult Difficult Asthma Care

Difficult-to-treat (or difficult) asthma presents a challenging multidimensional model of chronic disease that imposes a significant burden at both individual patient and wider societal levels. Within that model of disease there is increasing understanding of the diverse range of asthma phenotypes that might be encountered. There is also the growing realisation that these do not occur in isolation but exist within a wider multimorbidity disease framework. Identifying these other treatable traits that exist within the setting of difficult asthma has shown capability to improve patient outcomes. In that context, application of structured approaches to patient assessment have shown good efficacy, both at more general as well as specialist care levels. So too have multidisciplinary team approaches to difficult asthma care. The combined roles of the Asthma Specialist Physician, Asthma Nurse Specialist, Asthma Pharmacist, Speech & Language Therapist and Asthma Dietitian in that regard are evolving rapidly. In this chapter we review the multimorbidity model of difficult asthma and how best to approach that via multi-disciplinary team working approaches when undertaking specialist management of adult difficult asthma in clinical practice.