Allergists and pulmonologists were found to adhere to recommendations from the National Asthma Education and Prevention Program’s Third Expert Panel Report (EPR-3) guidelines, according to a study published in the Journal of Allergy and Clinical Immunology Practice.

A total of 134 allergists and 99 pulmonologists participated in the 2012 National Asthma Survey of Physicians conducted to assess guideline agreement, self-efficacy, and adherence to recommendations formulated in the EPR-3. Adherence to guideline recommendations was classified as “almost always” (≥75% of the time), “often” (25-75% of the time), “sometimes” (1-25% of the time), and “never” (0% of the time).

Survey participants reported strong self-efficacy in managing asthma for selected guideline recommendations (range, 81.3-92.8%), and  66.2% indicated “almost always” assessing asthma control by using an asthma control tool or asking patients a set of questions. A total of 71.3% of respondents reported assessing school/work asthma triggers in line with guideline recommendations, and 95.5% reported endorsing inhaled corticosteroids use as recommended.

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A greater percentage of allergists vs pulmonologists reported:  “almost always” performing spirometry (56.6% vs 38.6%, respectively; P =.06),  “almost always” asking about nighttime awakening (91.9% vs 76.5%, respectively; P =.03) and visits to the emergency department (92.2% vs 76.5%, respectively; P =.03), “almost always” assessing home triggers (70.5% vs 52.6%, respectively; P =.06), and performing allergy testing (61.8% vs 21.3%, respectively; P <.001). Practice-specific characteristics were found to account for these differences, with the exception of allergy testing.

Limitations of this study include the self-reported nature of the data.

“This study informs efforts to further improve asthma outcomes by improving specialist practice, especially in the area of assessment of inhaler technique,” concluded the study authors.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Cloutier MM, Akinbami LJ, Salo PM, et al. Use of national asthma guidelines by allergists and pulmonologists: A national survey [published online April 25, 2020]. J Allergy Clin Immunol Pract. 2020;S2213-2198(20)30377-9. doi: 10.1016/j.jaip.2020.04.026