Lily Higgins, MD: Treating Asthma Beyond the Guidelines

Current strategies in asthma care should include a multidisciplinary team approach as well as patient education to ensure proper use of inhalers, according to Lily Higgins, MD, MBA, MS.

Dr Higgins recently spoke about this topic at the American Lung Association’s LUNGFORCE Expo 2019. Lily Higgins, MD, MBA, MS, is the market chief medical officer at AmeriHealth Caritas in Philadelphia, Pennsylvania.

In addition to pulmonologists in attendance, Dr Higgins’ session also drew attention from respiratory therapists, COPD/respiratory educators, and pharmacists. And from the beginning of this interactive session the audience identified 2 major challenges associated with asthma medication adherence: technique and children cannot have more than one inhaler (for example, one for home use and one for school use).

This led to a discussion of how to properly use an inhaler and/or a spacer, at what point of the treatment course should patients be educated, and who should be educating patients. All attendees agreed that the prescribing physician or pulmonologist should take more time with patients, especially children, to ensure they know how to properly use their inhaler.

Moreover, children and some adults may still have a difficult time receiving the inhaled medication through their inhaler. At this point of treatment, Dr Higgins suggests prescribing a spacer and explaining to patients what it is and how to use it properly. In her experience, and supported by the diverse audience, spacers help reduce the rates of exacerbation and hospitalization in patients with asthma.

Dr Higgins also explained that her institution currently allows children to receive 2 inhalers and that other health care institutions are slowly following suit.

Other challenges identified during Dr Higgins’ session include creating an Asthma Action Plan for patients, overcoming language barriers between patients and staff, and how to manage situations in which parents are in denial about their children having asthma.

One way to overcome language barriers is to go through your insurance provider for a translator, which is often provided according to Dr Higgins. She also said if you explain the symptoms of asthma to parents, they will more likely believe the asthma diagnosis.

For more about Dr Higgins’ session, watch our video interview with her here.

—Amanda Balbi