Current Practices and Variations Among Pediatric Severe Asthma Programs in the United States—The North American Severe Pediatric Asthma Consortium
Year: 2026
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Severe and difficult to treat asthma in children is a complex condition causing significant morbidity and associated healthcare costs. While treatment guidelines exist for severe asthma, optimal treatment approaches for the pediatric population are less well established. Furthermore, best practices regarding real world management and implementation of guidelines for the severe pediatric asthma population are lacking. In order to provide care for this population, institutions around the United States have developed multidisciplinary severe pediatric asthma programs (SPAPs). In recent years, the North American Severe Pediatric Asthma Consortium (NASPAC) was established as a mechanism for SPAPs to collaborate and share expertise in pediatric severe asthma. We describe the structure of the individual programs within NASPAC, as well as similarities and differences between them. METHODS: Study design consisted of a cross-sectional observational framework model, utilizing a Redcap survey that was distributed to sixteen SPAPs in 2024. Survey questions included total and new patient volume, type of staff, frequency of SPAP sessions, eligibility criteria for enrollment in the SPAP, and typical initial evaluation once enrolled. Twelve centers had completed prior surveys regarding patient volume in 2018 and 2021, and this data was used for comparison. RESULTS: Fourteen centers responded to the 2024 survey. The centers were most similar in their incorporation of core personnel (pulmonologists, allergists, social workers, asthma educators), and the morbidity measures used for their clinic inclusion criteria. Almost all SPAPs had a basic initial evaluation including medication and technique review, adherence evaluation/discussion and spirometry. Significant variability was seen in presence of additional staff (psychologists, endocrinologists, nutritionists), and additional radiologic and laboratory testing at initial evaluation. DISCUSSION: Significant similarities exist among fourteen independent severe pediatric asthma programs throughout the United States. However, practice variability was evident between centers. The formation of NASPAC provides opportunities for research and collaborative initiatives, as well as to establish best practices for real world management of the severe and difficult to treat pediatric asthma population.
Source: Pediatric Pulmonology
DOI: 10.1002/ppul.71738
Authors: Kristina Gaietto, Nadia Krupp, Avani V. Shah, Erhan Ararat, Samantha H. Averill, Sachin Baxi, Matejka Cernelc‐Kohan, Jeffrey M. Chambliss, Heather De Keyser, Monica Federico, Bob Geng, Akilah A. Jefferson, Parisa Kaviany, Lila C. Kertz, Kirsten Kloepfer, Allyson Larkin, Sydney Leibel, Tanya Martinez‐Fernandez, Samira Naime, Robert D. Pesek, Dinesh K. Pillai, Deepa Rastogi, Katherine Rivera‐Spoljaric, Kristie R. Ross, Franziska J. Rosser, Tregony C. Simoneau, Jade Tam‐Williams, Kelan G. Tantisira, William Anderson, Jonathan M. Gaffin, Theresa W. Guilbert, Erick Forno
Institutions: University of Pittsburgh, Indiana University Indianapolis, Indiana University School of Medicine, Northwestern University, University of Arkansas Medical Center, University of Arkansas for Medical Sciences, Boston Children's Hospital, Harvard University, University of California San Diego, Rady Children's Hospital-San Diego, The University of Texas Southwestern Medical Center, Children's Hospital Colorado, University of Colorado Anschutz, Children's National, George Washington University, Washington University in St. Louis, Children's Mercy Hospital, University of Missouri–Kansas City, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cincinnati Children's Hospital Medical Center, University of Cincinnati
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,740
OpenAlex ID: W7169586315