RESPIRATORY MEDICINE – ASTHMA PROGRAM

ASTHMA CLINICS

ABOUT THE ASTHMA CLINICS

Calgary Respiratory Medicine provides outpatient Asthma Clinics in each of Calgary’s four adult hospitals, including diagnosis, management, treatment and education for patients living with asthma.

Our Asthma Clinics are supported by Respirologists, Respiratory Therapists, Certified Respiratory Educators (CRE) and Pharmacists whose common goal is to help patients with asthma live symptom free.

Each clinic is associated with Level 3 Pulmonary Function Labs and the most advanced technology available to measure how well lungs are working or to detect uncontrolled inflammation in the lungs, including:

  • Spirometry
  • Methacholine challenge testing for asthma diagnosis
  • Induced sputum analysis for assessment of difficult to control asthma (Calgary’s Dr. Richard Leigh was a pioneer in the development of this technique and we are proud to be one of only five sites in Canada to offer this specialized testing)
  • Cardiopulmonary Exercise Test providing detailed information about cardiopulmonary health

Asthma does not have to control your life. With appropriate treatment, most people with asthma can be free of symptoms and participate fully in the activities they enjoy.

Controlled asthma, even for those with severe symptoms, is the main goal of our dedicated team of nationally and internationally recognized experts.

SEVERE ASTHMA CLINICS

For patients suffering from severe or uncontrolled asthma, we offer specialty clinics with multidisciplinary teams at the Foothills Medical Centre and Rockyview General Hospital. Patients seen at a Severe Asthma Clinic have greater disease management options including advanced therapeutic medications (biologics), specialized treatment including bronchial thermoplasty, and access to mental health support groups. In most cases, our Respirologists can significantly improve or eliminate the asthma-related symptoms these patients experience.

Signs of uncontrolled asthma include visits to the emergency room, nighttime awakening, and using a rescue inhaler multiple times per week.

ADOLESCENT TRANSITION CLINICS

Adolescents with moderate to severe asthma previously seen at the Alberta Children’s Hospital who are ready to transition to the adult clinic are now directly referred to the Asthma Transition Clinic at Rockyview General Hospital. This is a weekly clinic directed towards the ongoing care of young patients as they transit into the adult healthcare system. The clinic provides support through a multitude of specialists including Respiratory Physicians, Respiratory Therapists, and Certified Respiratory Educators, if needed.

REFERRAL CRITERIA

Access to the Asthma Clinics is by referral only. Urgent referrals denote patients seen in an Emergency Department or who are admitted to hospital for asthma symptoms. Other referral options include:

  • For query asthma or improved asthma management: family physician referral through Pulmonary Central Access and Triage (PCAT)
  • Patients with severe uncontrolled asthma: Respirologist or specialty care referral
  • Patients transitioning from pediatric to adult care: Respirologist or specialty care referral

Typical wait times are:

  • 3 months to 1 year for a general appointment
  • Less than 1 month for an urgent referral

CERTIFIED RESPIRATORY EDUCATOR ACCESS

Your initial clinic appointment may include an assessment with a CRE to learn proper inhaler techniques and to receive educational information and materials about managing asthma symptoms.

RESOURCES FOR PATIENTS AND CAREGIVERS


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CLINICAL TRIALS

Our Respirologists and other University of Calgary Department of Medicine researchers run cutting edge clinical trials that Asthma Clinic patients may be eligible to participate in.

Participation in our asthma research provides many benefits for patients including access to our world-class physicians, new treatment approaches and medications, and additional patient education.

Visit www.ucalgary.ca/anewbreath or contact us to learn more about current clinical trials for asthma treatment.


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SEVERE ASTHMA FELLOWSHIP PROGRAM

The Advanced Fellowship in Severe Asthma was started in March of 2021 and provides in depth clinical training on the diagnosis and management of severe asthma, mentorship in clinical research, and mentorship on establishing a clinical program in severe asthma.

Required Documents for Applications: Letter of intent, CV, 3 letters of support, including one from the Respirology Training Program Director

Partial funding is available for successful applicants

  • Start Date: July 1 (flexible)
  • Duration of Fellowship: 1 year
  • Number of Positions per Year: 1
  • Application Deadline: 5 pm MST October 31

Other Prerequisites: Applicants must have obtained Royal College of Physicians and Surgeons of Canada (RCPSC) certification in Internal Medicine and must be on track to complete (or have obtained) RCPSC certification in Adult Respirology. Applicants must be eligible for licensure in Alberta (this requires completion of the Canadian Licentiate of Medical Council of Canada (LMCC) exams).

Fellowship Director: Dr. Brandie Walker (b.walker@ucalgary.ca)
Contact person and contact information: Dianne Aronyk (dianne.aronyk@ucalgary.ca)

Dr. Brandie Walker
b.walker@ucalgary.ca
403 220 4135
#1007 Health Sciences Centre
3330 Hospital Drive NW
Calgary AB T2N 4N1


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MEET THE ASTHMA CLINIC TEAM

Dr. Brandie Laurel Walker, MD, PhD, FRCPC, Clinical Lead
Dr. Walker is a University of Calgary trained Respirologist with a focus on airways diseases. She runs specialty clinics in both severe asthma as well as a multidisciplinary severe COPD clinic at Foothills Medical Centre. Dr. Walker has been Medical Director of the Calgary COPD and Asthma Program since 2014. She is the Respirology Site Lead for the Foothills Medical Centre as well as the site lead for the Respirology training program. She is program director for the Severe Asthma Fellowship Program at the University of Calgary. She is a member of the Airways Research Group at the University of Calgary and participates in clinical and pharmaceutical asthma and COPD research studies.

Dr. Richard Leigh, MBChB, MSc, PhD, FCP (SA), FRCPC, Asthma Research Lead
Richard Leigh is a physician-scientist and the Senior Associate Dean – Faculty Affairs in the Cumming School of Medicine at the University of Calgary.

He obtained his medical degree from the University of Cape Town, and subsequently undertook specialist and sub-specialist training in Internal Medicine and Pulmonology at the University of Cape Town, South Africa. This was followed by further research training in the areas of airway inflammation, asthma and COPD at McMaster University in Canada, where obtained a Masters degree in Health Research Methodology and a PhD in Medical Sciences.

Dr. Leigh’s areas of interest include understanding the basic mechanisms underlying airway remodeling in asthma, the assessment of airway inflammation and early phase clinical trials in asthma and COPD. His program of research studying the role of rhinovirus infections in the pathogenesis of airway remodeling in asthma is funded through a CIHR Project Grant.

His clinical practice focuses on severe asthma and other airways diseases, and he previously served as the Division Chief of Respiratory Medicine and as the Chair of the Department of Medicine before taking up his current appointment in January 2020.

Dr. Stephen K. Field, MD, CM, FRCPC, DABIM, CSPQ, FCCP
Dr. Field is a respirologist at Foothills Medical Centre and clinical professor at the University of Calgary. He has a large respiratory consultative practice and works in the tuberculosis and nontuberculous mycobacterial clinics. He cofounded the Calgary COPD and asthma program and founded the Calgary chronic cough clinic. Dr Field has participated in numerous clinical investigations and published over 100 articles in peer-reviewed journals as well as many abstracts, book chapters, and communications.

Dr. J. Michael Ramsahai, MD, FRCPC
Dr. Ramsahai completed his training in Adult Respirology at the University of Calgary before pursuing advanced training in Severe Asthma at the John Hunter Hospital and University of Newcastle in Australia. Since then, his practice based at the Rockyview General Hospital sees general respirology and severe asthma patients. He is currently the physician lead for the Adolescent Transition Asthma Clinic based at the same site, and the Medical Director for the Calgary Zone Pulmonary Function Labs. He is the primary physician preceptor for the severe asthma fellowship program at the Rockyview General Hospital and is an active member of the Airways Research Group at the University of Calgary.

RESEARCH AND PUBLICATIONS

https://scholar.google.ca/citations?user=fA9sTcwAAAAJ&hl=en&oi=ao

  • Erika Penz, Michael Stickland and Brandie Walker. Chronic Obstructive Pulmonary Disease (Year in Review). Canadian Journal of Respiratory, Critical Care and Sleep Medicine 2021, Vol 5, No 2, 84-88.

  • Leung C, Bourbeau J, Sin DD, Aaron SD, FitzGerald JM, Maltais F, Marciniuk DD, O’Donnell D, Hernandez P, Chapman KR, Walker B, Road JD, Zheng L, Zou C, Hogg JC, Tan WE The Prevalence of Chronic Obstructive Pulmonary Disease (COPD) and the Heterogeneity of Risk Factors in the Canadian Population: Results from the Canadian Obstructive Lung Disease (COLD) Study.; Int J Chron Obstruct Pulmon Dis. 2021 Feb 12;16:305-320.

  • Selvanathan J, Aaron SD, Sykes JM, Vandemheen KL, FitzGerald JM, Ainslie M, Lemière C, Field SK, McIvor RA, Hernandez P, Mayers I, Mulpuru S, Alvarez GA, Pakhale S, Mallick R, Boulet LP, Gupta S, for the Canadian Respiratory Research Network. Diagnostic accuracy and reliability of spirometry with bronchodilator testing and serial methacholine challenge testing for diagnosis of adult asthma. Chest 2020 Aug; 158(2):479-DOI: https://doi.org/10.1016/j.chest.2020.03.052

  • Preteroti M, Whitmore GA, Vandemheen KL, FitzGerald JM, Lemière C, Boulet LP, Penz E, Field SK, Gupta S, McIvor RA, Mayers I, Hernandez P, Lougheed D, Ainslie M, Licskai C, Azher T, Fraser I, Mahdavian M, Aaron SD. Population-Based Case-Finding to Identify Subjects with Undiagnosed Asthma or COPD. Eur Respir J. 2020 Jun 18;55(6):2000024. doi: 10.1183/13993003.00024-2020. Print 2020 Jun. Eur Respir J. 2020. PMID: 32299864

  • Barrecheguren M, Pinto L, Mostafavi-Pour-Manshadi SM, Tan WC, Li PZ, Aaron SD, Benedetti A, Chapman KR, Walker B, Fitzgerald JM, Hernande P, Maltais F, Marciniuk DD, O’Donnell DE, Sin DD, Bourbeau J; Identification and Definition of Asthma-COPD Overlap: The CanCOLD Study. Respirology 2020 Feb 16.

  • Makhinova T, Walker BL, Gukert M, Kalvi L, Guirguis LM; Checking Inhaler Technique in the Community Pharmacy: Predictors of Critical Errors.. Pharmacy. 2020 Jan 7;8(1):6.

  • Sharpe H, Claveria-Gonzalez FC, Davidson W, Befus AD, Leung JP, Young E, Walker B;Adult Asthma Diagnosis: Physician Reported Challenges in Alberta-Based Primary Care Practices. Asthma Working Group, Respiratory Health Strategic Clinical Network, Alberta Health Services. SAGE Open Nurs. 2020 May 25;6.

  • Tan WC, Bourbeau J, Aaron SD, Hogg JC, Maltais F, Hernandez P, Marciniuk DD, Chapman KR, To T, Fitzgerald JM, Walker BL, Road J, Zheng L, Zhou G, Yao T, Benedetti A, O’Donnell D, Sin DD. The Effects of Marijuana Smoking on Lung Function in Older People. Eur Respir J. 2019 Dec 19;54(6)

  • Shorofsky M., Bourbeau J., Kimoff R., Jen R., Malhotra A., Ayas N., Tan W., Aaron S., Sin D., Road J., Chapman K., O’Donnell D., Maltais F., Hernandez P., Walker B., Marciniuk K., Kaminska M; Impaired Sleep Quality in COPD is Associated with Exacerbations: The CanCOLD cohort study. CHEST Nov. 2019 156(5):852 10

  • CanCOLD study investigators Aaron SD, Chapman KR, Fitzgerald JM, Hernandez P, Marciniuk DD, Maltais F, O’Donnell DE, Sin D, Walker BL, Paine NJ, Bacon SL, Bourbeau J, Tan WC, Lavoie KL; Psychological Distress is Related to Poor Health Behaviours in COPD and NonCOPD Patients: Evidence from the CanCOLD study.. Respir Med. 2019 Jan;146:1-9.

  • Field SK. Chronic refractory cough: what to do when inhalers, nasal sprays and pills don’t work. CJRCCSM 2018 2018;2(4):194-199 epub. 2018 Oct 22

  • Tan WC, Bourbeau J, Aaron SD, Zhou G, Maltais F, Hernandez P, Fitzgerald JM, Marciniuk DD, Walker B, Sin DD; Global Initiative for Chronic Obstructive Lung Disease 2017 Classification and Lung Function Decline in Chronic Obstructive Pulmonary Disease.. Am J Respir Crit Care Med 2018 Mar 1;197(5):670-673;

  • Dean BW, Birnie EE, Whitmore GA, Vandemheen KL, Boulet L-P, FitzGerald JM, Ainslie M, Gupta S, Lemiere C, Field SK, McIvor RA, Mayers I, Aaron SD. Between visit variability in FEV1 as a diagnostic test for asthma in adults. Annals American Thoracic Society 2018 Sept 1;15(9):1039-46 2018 Jun 7. Doi: 10.1513/Annals ATS 201803-211OC

  • Field SK, Escalante P, Fisher DA, Ireland B, Irwin RS on behalf of the CHEST Expert Cough Panel. Cough due to tuberculosis and other chronic infections: Chest guideline and expert panel report. Chest 2018;153(2):467-497 (2017), doi: 10.1016/j.Chest.2017.11.018

  • Field SK, Conley DP, Paramchuk L, Walker BW, Leigh R. Is there a role for certified respiratory educators in the assessment and management of some chronic cough patients? Primary Health Care: Open Access 2017, 7:1 1000264 DOI: 10.4172/2167-1079.1000264

  • De Sousa Sena R, Ahmed S, Tan WC, Li PZ, Labonte L, Aaron SD, Benedetti A, Chapman KR, Walker B, Fitzgerald JM, Hernandez P, Maltais F, Marciniuk DD, O’Donnell DE, Sin DD, Bourbeau J; Work Productivity Loss in Mild to Moderate COPD: Lessons Learned From the CanCOLD Study. CanCOLD Collaborative Research Group and the Canadian Respiratory Research Network. Eur Respir J. 2017 Sep 12;50(3);

  • Aaron SD, Vandemheen KL, FitzGerald JM, Ainslie M, Gupta S, Lemiere C, Field SK, McIvor RA, Hernandez P, Mayers I, Mulpuru S, Alvarez GG, Pakhale S, Mallick R, Boulet LP. Reevaluation of diagnosis in adults with physician-diagnosed asthma. JAMA 2017;317(3):269-279

  • Peter J Kahrilas, Kenneth Altman, 78. Anne B. Chang, Stephen K. Field, Susan M. Harding, Andrew Lane, Kaiser Lim, Lorcan McGarvey, Jacqueline Smith, and Richard S. Irwin MD, Master FCCP on behalf of the CHEST Expert Cough Panel*. Chronic Cough due to Gastroesophageal Reflux in Adults: CHEST Guideline and Expert Panel Report CHEST 2016;150(6):1341-60

  • Gupta N., Pinto L, Benedetti A, Li P, Tan W, Aaron S, Chapman K, FitzGerald J, Hernandez P, Marciniuk D, Maltais F, O’Donnell D, Sin D, Walker B, and Bourbeau J., The COPD Assessment Test: Can it Discriminate Across COPD Subpopulations? CHEST 2016 Nov; 150(5);


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