Dr. William Anderson: Asthma Is Not Just a Disease of the Lungs

May 23, 2025 · Becky Kolinski

In honor of Asthma Awareness Month, we interviewed William Anderson, MD, Associate Professor of Pediatrics at Children’s Hospital Colorado and the University of Colorado School of Medicine. He is a national expert on asthma care and participated in NCQA’s Asthma Management and Education Roundtable. He shared his perspective on the challenges and opportunities in asthma care today.

What were some of your key takeaways from NCQA’s asthma roundtable?

My biggest ‘aha moment’ was hearing the group compare asthma to other diseases in the U.S. that get more attention, like diabetes or heart disease. Think of all the money we spend on diabetes care coordination and diabetes educators. We have those same types of professionals for asthma, but they don’t get the same level of emphasis in the health care system. One of the other physicians told me: “If a patient goes into the hospital for chest pain or a heart attack, they’re not going to just give them some medicine and send them out the door.” But that’s exactly what we do for patients with asthma exacerbations.

What is a common misunderstanding about asthma?

It’s overly simplistic to think of asthma as just a disease of the lungs. We need to consider the effects of the environment, whether it’s pollen, pollution or smoke exposure. We need to understand how asthma impacts a patient’s ability to go to work or school, to perform daily chores and to take medicine. Asthma is more than just what’s happening in the lungs. It’s what’s happening in people’s lives and the environment around them.

What challenges do patients experience when trying to access high-quality asthma care?

The vast majority of patients I work with are on Medicaid, so it’s definitely an underserved population. A lot of patients end up in our severe asthma clinic due to psychosocial aspects of care. It could be that they don’t have regular support with a health care provider, whether that’s a primary care provider or an asthma specialist. Or they might have difficulty accessing the medications they need.

The biggest challenge for children and their families is understanding how this disease fits into their day-to-day life. A lot of parents and caregivers are taking care of multiple kids and working multiple jobs just to keep food on the table, so health care can sometimes fall lower on their priority list. As clinicians, we see the patient for maybe 10–20 minutes every couple months—but they’re living with asthma every day. So, we need to think about what’s happening in homes, schools and communities that may prevent patients from being able to follow their treatment plan.

One of your clinical interests is the transition from pediatric to adult care. Why is that important?

A lot of people think asthma is just a disease of childhood, but it can persist through adolescence and into adulthood. We need to empower adolescents to manage their asthma and teach them the skills they need to take the reins from their parents. We want to make sure they’re set up for success. There have been a lot of studies that show that people who don’t successfully transfer from pediatric to adult care tend to end up in the emergency department more frequently, have more hospitalizations and experience more frequent exacerbations, so we’re trying to avoid that.

What challenges do providers experience when trying to deliver high-quality asthma care?

Primary care providers have to manage such a wide swath of conditions in a limited time, so it can be hard to keep up with the literature for one particular disease. It is important to have easy to follow guidelines for managing patients in their practice and knowing when to refer to a specialist. But that can also be a challenge, because not everywhere in the country has access to asthma specialists, especially in rural areas.

For specialists, variation in insurance coverage and formularies is a challenge. If a patient is well controlled on one therapy, and the insurance company changes the formulary, the patient has to switch medications. If the patient has a delay in accessing the new medication, or doesn’t understand how that medication works, it can lead to exacerbations. Biologics are a wonderful therapy option for patients with severe asthma, but it can be an uphill battle to get those medications approved.

What’s one thing you wish you could change or improve about asthma care in the U.S.?

The more I take care of patients with asthma, the more I realize how important it is to personalize the care. We do our best to create personalized care plans, but we don’t have the resources to understand exactly what’s happening at home or school, or what the drivers are for taking or not taking medicine. One of the ideas we discussed during the roundtable was to have a trained workforce—and adequate reimbursement—for home visits to understand each patient’s unique situation and help them make changes in their environment and daily routine that can prevent asthma exacerbations. That’s what I’m hoping we’ll see in the future.

Learn More

Read the white paper, Improving Outcomes for People with Asthma: Challenges and a Call to Action.