When should patients with asthma be referred for additional consultations?

Updated: Jan 07, 2019
  • Author: Michael J Morris, MD, FACP, FCCP; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Refer any patient with moderate-to-severe persistent asthma that is difficult to control to a pulmonologist or allergist to ensure proper stepwise asthma management, or refer for further evaluation to help rule out other diagnoses such as VCD/ILO. Also, abnormalities found on chest radiography screening should prompt referral to a specialist for further evaluation.

Refer patients to an allergist or immunologist for skin testing to guide indoor allergen mitigation efforts and consideration of immunotherapy to treat seasonal allergic rhinitis.

Refer patients to a pulmonologist for evaluation of symptoms consistent with exercise-induced bronchoconstriction (EIB). These patients should undergo either exercise or bronchoprovocation testing to document evidence of airway hyperreactivity and response to exercise.

Refer patients to an otolaryngologist for treatment of nasal obstruction from polyps, sinusitis, or allergic rhinitis or for the diagnosis of upper airway disorders.


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