Personalised management and supporting individuals to live with their asthma in a primary care setting

Abstract

Introduction: Complementing recognition of biomedical phenotypes, a primary care approach to asthma care recognises diversity of disease, health beliefs and lifestyle at a population and individual level. Areas covered:We review six aspects of personalised care particularly pertinent to primary care management of asthma: personalising support for individuals living with asthma; targeting asthma care within populations; managing phenotypes of wheezy pre-school children; personalising management to the individual; meeting individual preferences for provision of asthma care; optimising digital approaches to enhance personalised care. Expert opinion: In a primary care setting, personalised management and supporting individuals to live with asthma extend beyond the contemporary concepts of biological phenotypes and pharmacological ‘treatable traits’ to encompass evidence-based tailored support for selfmanagement, and delivery of patient-centred care including motivational interviewing. It extends to how we organise clinical practices and the choices provided in mode of consultation. Diagnostic uncertainty due to recognition of phenotypes of pre-school wheeze remains a challenge for primary care. Digital health can support personalised management, but there are concerns about increasing inequities. This broad approach reflects the traditionally holistic ethos of primary care (‘knowing their patients and understanding their communities’), but the core concepts resonate with all healthcare