Lack of awareness about biologics for asthma widespread among primary care doctors

Many primary care physicians (PCPs) appear to be inadequately informed about the role of biologics in managing asthma, as shown in a study.

“Asthma is a common, chronic airway disease associated with substantial morbidity,” said lead study author Dr Bijalben Patel from Morsani College of Medicine at the University of South Florida in Tampa, Florida, US.

“Most patients with uncontrolled asthma in the US are managed by PCPs and not by asthma specialists who are more frequently updated on asthma treatment advances, including biologics, which decrease asthma exacerbation rates,” Patel added.

In a survey of 85 PCPs, 77 percent responded that they only referred their patients to specialists after two or more exacerbations per year. [ACAAI 2023, abstract P110]

“It is important to note that regardless of the frequency of asthma patients [evaluated in a clinic (ie, from never/once a month to every 2 weeks and at least once a week)], majority of the referrals were happening after two exacerbations in a year,” Patel noted.

More importantly, 42 percent and 46 percent of PCPs stated they were unfamiliar or somewhat familiar with biologic therapy, respectively. This pattern also remained consistent regardless of the frequency of asthma patients seen in clinic, Patel added.

In terms of whether laboratory values were used in a primary care setting, 82 percent of PCPs did not order lab work and 90 percent did not use absolute eosinophil count to guide asthma management.

“It was also interesting to note that PCPs who saw asthma patients more frequently and those who referred patients to a specialist were more likely to get lab work to manage asthma (p=0.020 and p=0.029, respectively),” Patel said.

Patel and colleagues administered a REDCap (Research Electronic Data Capture) survey via email, with the respondents comprising primary care attending and resident physicians in the Departments of Internal Medicine, Family Medicine, and Pediatrics.

“In conclusion, our results demonstrate that even in an epidemic centre, there is an unmet need to empower the PCP community to better care for [patients with] asthma and to improve the current education … given to PCPs,” Patel said.

She stressed that improving the PCPs’ knowledge of asthma treatment options and treatable traits will likely result in a more appropriate referral patterns to asthma specialists, and this should help optimize treatment with the appropriate use of biologics.

“The intended goal is to decrease asthma exacerbations and healthcare expenditures, improve the quality of life of the patients, and minimize the risk related to the use of systemic corticosteroids,” Patel pointed out.