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Improved Care for Patients with Moderate-to-Severe Asthma: Reflecting on Errors and Missed Opportunities

  • Authors: Ratko Djukanovic, MD, DM, FRCP (Chair), Stephen P. Peters, MD, PhD, FAAAAI, FACP, FCCP, FCPP, Michael E. Wechsler, MD, MMSc
  • CME Released: 12/31/2019
  • Valid for credit through: 12/30/2020
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Target Audience and Goal Statement

The target audiences for this activity are allergy/immunology and pulmonology physicians practicing outside of the United States, who manage patients with moderate-to-severe asthma.

The goal of this activity is to foster recognition of missed opportunities and suboptimal care among patients with moderate-to-severe asthma, thereby helping clinicians who treat these patients examine best practice for management.

Upon completion of this activity, participants will:

  1. Distinguish between the different types of asthma based on underlying pathophysiology and biomarkers of disease in order to make personalized treatment decisions
  2. Identify patients with poorly controlled or difficult-to-treat asthma who are eligible for step-up therapies, including new and emerging biologics
  3. Incorporate new and emerging targeted biologics into the management of patients with severe or poorly controlled asthma when appropriate


It is the policy of RMEI Medical Education, LLC and Advancing Knowledge in Healthcare, Inc. (AKH) to ensure independence, balance, objectivity, scientific rigor, and integrity in all of their continuing education activities. The faculty must disclose to the participants any significant relationships with commercial interests whose products or devices may be mentioned in the activity or with the commercial supporter of this continuing education activity. Identified conflicts of interest are resolved by RMEI and AKH prior to accreditation of the activity and may include any of, or a combination of, the following: attestation to non-commercial content; notification of independent and certified CME/CE expectations; referral to National Faculty Initiative training; restriction of topic area or content; restriction to discussion of science only; amendment of content to eliminate discussion of device or technique; use of other faculty for discussion of recommendations; independent review against criteria ensuring evidence supports the recommendation; moderator review; and peer review.


Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications. The opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


  • Ratko Djukanovic, MD, DM, FRCP (Chair)

    Professor, Medicine, Director, Southampton NIHR Respiratory Biomedical Research Unit, Director, NIHR Southampton Centre for Biomedical Research, Southampton, United Kingdom


    Disclosure: Ratko Djukanovic, MD, DM, FRCP, has disclosed the following relevant relationships:
    Synairgen PLC (Stock); AstraZeneca, Novartis, TEVA (Speakers Bureau); Novartis, TEVA (Consultant).

  • Stephen P. Peters, MD, PhD, FAAAAI, FACP, FCCP, FCPP

    Thomas H. Davis Chair, Pulmonary Medicine, Chief, Section on Pulmonary, Critical Care, Allergy & Immunologic Diseases, Professor, Internal Medicine, Pediatrics and Translational Science, Wake Forest Baptist Health, Winston-Salem, North Carolina


    Disclosure: Stephen P. Peters, MD, PhD, FAAAAI, FACP, FCCP, FCPP, has disclosed the following relevant relationships:
    AstraZeneca, CVS Caremark, Genentech, Mylan, Novartis, Regeneron, Sanofi, TEVA, Theravance (Consultant).

  • Michael E. Wechsler, MD, MMSc

    Co-Director, The Cohen Family Asthma Institute, Professor, Department of Medicine, National Jewish Health, Denver, Colorado


    Disclosure: Michael E. Wechsler, MD, MMSc, has disclosed the following relevant relationships:
    AstraZeneca, Equillium, GlaxoSmithKline, Mylan, Novartis, Regeneron, Restorbio, Sanofi, Teva (Consultant); AstraZeneca, Regeneron, Restorbio, Sanofi, Teva (Contracted Research).

AKH Staff Disclosures

  • Dorothy Caputo, MA, BSN, RN


    Dorothy Caputo, MA, BSN, RN, Lead Nurse Planner: has disclosed no financial relationships.

  • Patricia Brignoni


    Patricia Brignoni, AKH Director of Operations/Reviewer: has disclosed no financial relationships.

  • Disclosures

    AKH planners and reviewers have no relevant financial relationships to disclose. RMEI Medical Education, LLC planners and managers have nothing to disclose.

Accreditation Statements

CME credit provided by AKH Inc., Advancing Knowledge in Healthcare.

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of AKH Inc., Advancing Knowledge in Healthcare and RMEI Medical Education, LLC. AKH Inc., Advancing Knowledge in Healthcare is accredited by the ACCME to provide continuing medical education for physicians.

    For Physicians

  • AKH Inc., Advancing Knowledge in Healthcare designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 Credit(s) ™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Contact This Provider

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]

Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit ™, you must receive a minimum score of 75% on the post-test.

Follow these steps to earn CME/CE credit*:

  1. Read the target audience, learning objectives, and author disclosures.
  2. Study the educational content online or printed out.
  3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. We encourage you to complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates from the CME/CE Tracker.

*The credit that you receive is based on your user profile.


Improved Care for Patients with Moderate-to-Severe Asthma: Reflecting on Errors and Missed Opportunities

Authors: Ratko Djukanovic, MD, DM, FRCP (Chair), Stephen P. Peters, MD, PhD, FAAAAI, FACP, FCCP, FCPP, Michael E. Wechsler, MD, MMScFaculty and Disclosures

CME Released: 12/31/2019

Valid for credit through: 12/30/2020


ACQ = Asthma Control Questionnaire
CRP = C-reactive protein
FeNO = fractional exhaled nitric oxide
FEV1 = forced expiratory volume in 1 second
FVC = forced vital capacity
GORD = gastro-oesophageal reflux disease
PGD2 = prostaglandin D2
ppb = parts per billion
PPI = proton pump inhibitor
SNOT = Sino-Nasal Outcome Test
TSLP = thymic stromal lymphopoietin

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