Continuing asthma and COPD care in Spain

Terms used

• Médico de familia — The médico de familia is your family doctor at the public health centre, who handles most care and referrals.
• Neumología — Neumología is the hospital pneumology department, which treats lung conditions such as asthma and COPD.
• Receta electrónica — The receta electrónica is the electronic prescription that lets you collect medicines at any pharmacy with your health card.
• Calima — Calima is Saharan dust carried over Spain, which can worsen breathing problems.

Key rules

• Specialist access: You reach a lung specialist through a referral from your family doctor, except in emergencies.
• Inhalers: Your doctor prescribes chronic inhalers electronically, and you collect them at any pharmacy with your health card.
• Waits: Specialist waits vary by region, from weeks to several months.
• Climate: Heat, city pollution, dust and pollen differ by region, so check them before choosing where to live.

Start with your family doctor

Your family doctor (médico de familia) at your health centre is the way in. Book an appointment and bring your diagnosis, your current medicines and any recent test results.

The doctor will assess your symptoms and usually order spirometry, a breathing test. Many health centres do it on site. Others send you to the hospital. Mild to moderate asthma or COPD is often managed entirely at the health centre.

When you get a pneumology referral

You see a lung specialist in hospital pneumology (neumología) only through a referral from your family doctor. Ask for one if:

• your diagnosis is unclear,
• your control is poor,
• you have frequent flare-ups, or
• your disease is severe.

Without a referral, direct access is limited to emergencies (urgencias). The hospital sends your appointment by letter, SMS, app or phone, or you get it at your health centre. Waits run from weeks to several months and depend on your region and specialty. Each region publishes its waiting-list data.

Once a specialist follows you, they book your review appointments themselves.

This route is for people in the public system. Private insurance and mutuas such as MUFACE follow their own routes, so ask your insurer.

Inhalers and what you pay

Your family doctor or pneumologist puts chronic inhalers on the electronic prescription (receta electrónica). You collect them at any pharmacy with your health card.

You pay a co-payment that depends on your income and status. Pensioners pay a reduced share with a monthly cap. Some newer or costly inhalers need approval from the health service's inspectors first, so ask your doctor early if yours is one of them.

Weigh heat and air quality when choosing where to live

Where you live changes how often your lungs flare up. Compare these before you commit to a place. The decision below helps you choose.

• Summer heat: It is most severe in the Guadalquivir valley, Extremadura, Murcia, inland Valencia and the Ebro valley. Heat waves raise your risk of flare-ups.
• Big cities: Nitrogen dioxide and particles are highest in Madrid and Barcelona. Ozone peaks in summer in Madrid, the Barcelona area, Puertollano and along the Mediterranean coast.
• Saharan dust (calima): It affects the Canary Islands most. It reaches the south and the Mediterranean at times.
• Pollen: Grass pollen peaks in spring in central and southern Spain. Olive pollen peaks in May and June in Andalusia and Jaén. Cypress-family pollen peaks in winter in Catalonia and Madrid. Parietaria is a problem on the Mediterranean coast.

Once you live somewhere, follow your area's heat warnings, air-quality readings and pollen alerts. The Ministry of Health's heat-prevention advice is also worth reading before summer. Conditions change daily.

Use the checklist below for the order of steps, and the FAQ for quick answers.

Choosing between options

Which part of Spain suits your asthma or COPD best?

• Hot inland areas: Fits if heat is not a trigger for you. The Guadalquivir valley, Extremadura, Murcia, the Valencia interior and the Ebro valley have the most severe summer heat, which raises flare-up risk.

• Big cities: Fits if traffic fumes and ozone do not set you off.

• Mediterranean coast: Fits if you are not sensitive to ozone or Parietaria pollen, which are both strong on this coast, and you can handle occasional calima.

• Canary Islands: Fits if Saharan dust (calima) does not trigger you, since the islands are affected most.

Pick the area whose main risk is not your main trigger. If heat or pollution sets off your symptoms, avoid the areas listed for it, and ask your family doctor or pneumologist before you choose.

Checklist

• Book an appointment with your family doctor at your health centre to review your asthma or COPD symptoms.

• Ask your family doctor to order spirometry, a breathing test, if you have no recent result.

• Ask for a referral to pneumology if your diagnosis is unclear, your control is poor, you have frequent flare-ups or your disease is severe.

• Watch for your hospital appointment by letter, SMS, app or phone, or ask at your health centre.

• Ask for your chronic inhalers on the electronic prescription and collect them at any pharmacy with your health card.

• Check your region's waiting-list data to see how long a specialist wait may take.

Frequently asked questions

Can I see a lung specialist without going through my family doctor?

No, in the public system you normally need a referral from your family doctor to see a pneumologist (lung specialist). Direct access without referral is limited to emergencies. Once the specialist follows you, they give you your review appointments.

Which parts of Spain are hardest on asthma and COPD in summer?

The hottest areas are the Guadalquivir valley, Extremadura, Murcia, the Valencia interior and the Ebro valley, where heat waves raise the risk of flare-ups. Ozone peaks in summer around Madrid, Barcelona and the Mediterranean coast. Calima, Saharan dust, hits the Canary Islands most.

When is pollen worst for asthma in Spain?

It depends on the plant and region: grass pollen peaks in spring in central and southern Spain, and olive pollen in May and June in Andalusia and Jaén.