Health disparities make guideline-based and self-management of asthma “unattainable for most,” according to a workgroup of the American Association of Allergy and Clinical Immunology. “Given the present state of health disparities by age, income, and race, the equitable implementation and dissemination of [the 2020 National Asthma Education and Prevention Program Update and Global Initiative for Asthma 2021] guidelines will be unlikely without further guidance.”
The workgroup report discusses the implementation of the guidelines given a lack of uptake by health professionals, childcare centers, and schools; poor care coordination; financial barriers; environmental factors; and poor access to subspecialists. The report also “reviews the current state of the new asthma guideline implementation; presents updated evidence-based therapeutic options with attention to specific patient populations; and addresses barriers to the implementation of these guidelines in minoritized, historically marginalized, and underresourced communities. Allergists and immunologists can use practical ways to accomplish the goals of improved asthma care access and advanced asthma care across the lifespan, with specific considerations to historically marginalized populations. Modifiable barriers to guideline implementation include financial barriers, environmental factors, and allergy subspecialty access and care coordination. Various programs to improve access to guideline-based asthma care include community programs, school-based asthma programs, and digital health solutions, with an emphasis on reducing disparities by race.”