Asthma Program

Aidan Long, MD of the Allergy and Immunology Unit discusses asthma.

Our Approach

At the Massachusetts General Hospital Asthma Program, we believe that an approach of delivering asthma care under emergency or urgent conditions is not ideal. We emphasize routine, longitudinal management and monitoring. Our primary goal is to enable patients to maintain normal lung function and a healthy lifestyle while avoiding unnecessary trips to the emergency room and hospital stays. In essence, we want our patients to control their asthma and not let the asthma control them. This includes identification and avoidance of triggers.

What to Expect

Every asthmatic patient's case is different, and we tailor our diagnostic and therapeutic approaches accordingly.

At your first appointment, you can expect an in-depth consultation with one of our allergy specialists. In order to diagnose asthma — and distinguish it from other lung disorders — we will likely perform:

• A physical examination
• A thorough evaluation of your medical history and environmental exposures in your home, your workplace and elsewhere, including a review of imaging studies and prior medications
• Allergy skin testing to identify which environmental allergens may be triggering your symptoms
• Breathing tests to assess lung function, including spirometry and peak flow monitoring

Following diagnosis, we will first recommend avoidance or minimizing exposure to the identified triggers. We will carefully explain which environmental factors may be causing your symptoms and how to make the necessary lifestyle changes.

Next, we will recommend medications (if necessary). Asthma medications typically take the form of inhalers and occasionally tablets. Our nurses have specialized advanced training as "Asthma Educators" and provide expert guidance on how to use and care for the inhaler devices.

The focus in asthma care is to tailor specific medications to specific subtypes of asthma, especially when that asthma is severe. For some patients with severe asthma, oral corticosteroids and/or therapy with newer biologic agents such as anti-immunoglobulin E (anti-IgE); anti-Interleukin-5; and anti-Interleukin-4 and -13; may be appropriate. These new agents, often referred to as biologics, can be administered in our Medical Infusion Center (with locations in both Boston and Waltham). There is a growing trend for these to be self-administered at home, something we actively will facilitate.

We embrace and adhere to the National Heart Lung and Blood Institute Asthma Management Guidelines and International Guidelines. These emphasize regular monitoring of the degree of control of the patient's asthma. Routine monitoring allows us to adjust your medication incrementally during periods of increased severity — and to reduce it during prolonged periods of good control, which helps you stay well and steer clear of medical crises. Our goal is to keep patients well on the least amount of medications necessary.

A Multidisciplinary Approach for Comprehensive Care

Our patients enjoy easy access to world-class clinicians from related specialties. We work closely with Mass General pulmonology specialists, ENT specialists and others, making it convenient for patients to have asthma-related exams, other tests and consultations.

About This Program

A Full Range of Asthma and Allergy Services

We offer a full range of asthma and allergy services, both at Mass General's main campus and at Mass General Waltham. Since we understand asthma can cause acute symptoms, we have a staff physician and a fellow on call 24/7 to answer patient questions and address emergency issues.

An important consideration for having an allergy specialist manage asthma is that it often represents a component of the patient’s allergic problems such as allergic rhinitis, allergic eczema and other conditions.

We are one of the only academic medical centers in Boston to treat both adults and children with asthma, which is important because asthma tends to run in families. Once we establish an effective treatment regimen for one patient, we can often take the same approach in caring for another family member. In addition, our patients enjoy the comfort that comes from receiving lifelong care at a single facility.

Treating Asthma in All Its Forms

We care for patients with all major forms of asthma. This includes allergic asthma (triggered by an allergy, often with an onset in childhood), non-allergic, late-onset asthma (developed later in life, frequently with no allergic basis), occupational asthma (caused by exposure to inhaled materials in the workplace) and drug-induced asthma (induced by medications such as aspirin or beta blockers). Appropriate classification of asthma is important for guiding treatment recommendations.

All of our allergy specialists treat asthmatic patients. Our team includes physicians who are nationally known for treating this condition and are leading the way in developing novel treatments and guidelines, as well as certified nurse asthma educators.

Groundbreaking Research

Many asthma-related research studies are taking place at Mass General, with the ultimate goal of translating findings into improved clinical care as soon as possible. In the area of basic science, our physicians are investigating the mechanism of disease of asthma.

• Nicole Lahood, MD