The Canadian Severe Asthma Network (CSAN) is an independent organization with a strong patient group with executive from across the country. CSAN has affiliations to Asthma Canada, the Canadian Lung Association, AllerGen, and the Canadian Respiratory Clinical Research Consortium.
CSAN has evolved over the years since its initial inception in 2008. Through multiple conference calls and annual workshops held initially in conjunction with the Canadian Respiratory Conference, CSAN developed a set of “clinical tools” to assist physicians and other health care workers review and optimize the quality of patient care for those with severe asthma in Alberta. These documents were standardized across Canada, and termed clinical standard operating protocols (“clinical SOPs”). The clinical SOPs can be used by healthcare workers for all patients with asthma – developed to assist with detailed patient assessments and longitudinal management. CSANs clinical SOPs have been distributed to different groups that care for asthma patients across the country.
A strong patient group executive with a medical director forms the key infrastructure to the maintenance phase of CSAN. Improving patient-centered care structures for individuals with asthma remains the focus – and in particular for individuals with severe asthma, the most difficult-to-control 5-10% of asthma patients. This will hopefully lessen the impact of asthma currently within our Canadian health care system (severe asthma accounts for 50-60% cost of asthma).
Primary Care – as is outlined in the Canada Health Act, the premise for management is that all patients have a primary care practitioner (PCP) whether a Family Physician, General Practitioner or Nurse Practitioner (with knowledge in pulmonary physiology) – working with the specialty asthma care team, which is not always the case.
Asthma Education in Severe Asthma – the routine education given for patients with asthma may not work well for severe (refractory) asthma. This is because of many reasons including unusual factors of their disease and most patients require quick attention (no yellow zone) when they get worse / have an exacerbation. The majority of educational materials available are for individuals with “regular” asthma.
CSAN will facilitate through our health network efficient dissemination related to new findings from research that will impact patient care. Please see pubmed hyperlinks to articles below:
1.ERS / ATS 2014 Statement of Severe Asthma –
2. Discussion on treatment of mild intermittent and mild persistent asthma (the majority of asthma).
O’Byrne. How much is too much? The treatment of mild asthma. ERJ 2007;30:403-406.
3. Early clinical trial on utility of add-on therapy of long-acting beta-agonists (FACET Trial)
Pauwels, Lofdahl, Postma, Tattersfield, O’Byrne, Barnes, Ullman. Effects of inhaled formoterol and budesonide on exacerbations of asthma. Formoterol And Corticosteroids Establishing Therapy (FACET) International Study Group. NEJM 1997;337(20):1405-11.
4. Severe Asthma Self-Management
Ross, Williams, Low, Vethanayagam. Perceptions about self-management in severe asthma. Journal of Asthma April 2010; 47(3):330-36.
5. Importance of measuring inflammation
Nair, O’Byrne. Measuring eosinophils to make treatment decisions in asthma. Chest 2016;150(3):485-87.