Member Champion, Karen Gregory: Improving Asthma Education, Equity, and Outcomes

Asthma care is evolving rapidly, creating new opportunities for respiratory therapists to improve patient outcomes through education, evidence-based protocols, and personalized care. In this Q&A, Karen L. Gregory, DNP, APRN, CNS, RRT, AE-C, FAARC, an advanced practice provider at Oklahoma Allergy & Asthma Clinic and assistant professor at Georgetown University School of Nursing, shares her insights on asthma guidelines, health equity, and the future of respiratory care.

From your perspective as an educator and clinician, what are some of the biggest opportunities respiratory therapists have to improve asthma outcomes today?

The sky’s the limit—we have so many great opportunities. As respiratory therapists, we need to be experts in educating people about asthma self-management and spirometry-driven protocols, which have been shown to significantly improve outcomes.

A 2023 article in Respiratory Care examined RT-driven protocols in outpatient settings and found that they significantly improved spirometry completion, increasing it from 64.9% to 92.7%. It also showed significant improvements in asthma education: When the RT was present, asthma education delivery increased from 62.6% to 88.5%.

Asthma education encompasses inhaler technique, self-monitoring, environmental control, and, most importantly, a written asthma action plan. I like to say that the written asthma action plan is our patient’s GPS. Every patient who walks out the door must have a written asthma action plan.

This RT-led education empowers patients with knowledge and confidence to manage their condition and reduces urgent care visits, missed school days, nighttime awakenings, and more. Patients trust us and believe in us—so we’re really well-positioned to provide asthma education.

How have emerging technologies and research changed the asthma landscape?

The Global Initiative for Asthma (GINA) releases guidelines every year, and I love them. They were first published in 1993 by a group of global asthma experts. They’re beyond incredible.

The 2025 severe asthma guideline specifies that, before escalating to a treatment such as a biologic therapy, we need to focus on optimizing modifiable risk factors: allergen avoidance, smoking cessation, and even weight loss.

Respiratory therapists see a lot of patients with difficult-to-control asthma, and GINA really stresses that distinguishing truly severe asthma from difficult-to-control asthma can be helpful, allowing us to best manage our patients.

There are now seven FDA-approved biologics for severe asthma. The most recent biologic is depemokimab (Exdensur), which was approved in December 2025. Biologics reduce severe asthma exacerbations.

One of the most exciting changes in asthma care is that we’re starting to see asthma remission become a realistic goal for some patients with severe asthma. Thanks to advances like biologic therapies, some patients are living with few or no symptoms and far fewer exacerbations. It’s changing the conversation from simply managing asthma to helping patients achieve the best possible long-term outcomes.

Patient adherence is often a major challenge. From your perspective, what have you found to be the most effective strategies for getting people to take their medication or improve their inhaler technique?

We need to implement shared decision-making—we have to let them be a part of managing this. We can’t say, “You’re going to administer your medication at this time; you’re going to follow this specific schedule.” Instead, identify their goals. What do they want to do?

Health equity is one of the areas I’m most passionate about because respiratory therapists can truly change lives. Many patients in underserved communities are doing the best they can while facing barriers we don’t always see. Our role is to meet them where they are—with education that’s easy to understand, action plans that are practical, and goals that are realistic and achievable.

Maybe we’re giving them reading materials they don’t understand, maybe their school environment is poor, or maybe we’re not culturally tailoring our education to meet their needs. We need to keep health equity in mind. If a patient isn’t adherent, maybe we need to take a deeper dive to understand why they aren’t following the plan.

When you think about the future of this profession, what skills or knowledge should RTs be seeking out?

I think RTs should focus on three areas. First, stay clinically current by understanding advances like biologics, precision medicine, and new respiratory technologies. Second, strengthen communication and patient education skills because helping patients understand and manage their disease is one of the greatest impacts we can have. And third, commit to lifelong learning. Healthcare evolves rapidly, and RTs who continue to learn, lead, and advocate for their patients will shape the future of the profession.

What encourages you about the future of asthma care?

We’re in an exciting period, including with precision medicine. We’re starting to see asthma in remission. It’s this new idea: asthma remission, just like cancer could be in remission. It’s opening up new opportunities for RTs to consider how we can help our asthma patients achieve remission.

Our role is also expanding beyond treating symptoms to helping identify the right therapy for the right patient, improving adherence, and supporting long-term disease control. What excites me most is the possibility that more patients may not only breathe better day-to-day but also experience fewer exacerbations, less dependence on corticosteroids, and a dramatically improved quality of life.

What drew you to this field?

I always wanted to go into medicine. My grandmother was a nurse, and I enjoyed the idea of following in her footsteps. I think going into medicine is a calling, and it was a calling for me. It’s been a passion my whole life.

Throughout my career, I’ve also had all these exciting opportunities and mentors who have been amazing along the way. I know a lot of respiratory therapists in my area who have been so encouraging.

My greatest motivation has always been the opportunity to make a meaningful difference in people’s lives. Whether I’m caring for patients, teaching future healthcare professionals, or contributing through education and research, I still feel the very same sense of purpose that inspired me to become a respiratory therapist. It is an honor and a privilege to do this work.