The National Australian Asthma Council Handbook was launched weeks ago. This update means we can now manage this disease with fewer puffers in adolescents and adults with asthma. Asthma treatment and prevention is now in one device.
What is asthma and why treatment is important
Asthma is a chronic inflammatory disease of the respiratory airways with airway tightening. Asthma is categorised by the frequency of symptoms. From infrequent episodic to frequent episodic to those with chronic persistent symptoms.
One in 9 Australians had asthma in 2022 which equates to 2.2 million people. Half of asthma sufferers do not have good control with them self-managing with the Blue Puffer Ventolin (Salbutamol). In 2022 to 2023, 31,000 people were hospitalised with asthma and about 97,000 people presented to emergency departments. In 2023 there were 474 deaths. 45% of deaths were in women over 75. At least 90% of these were potentially preventable.
The Blue Puffer is sold over the counter. There is an immediate relief with the tightening when inhaled. However, it does not treat the underlying inflammation. Because the underlying inflammation is still untreated. Three or more canisters bought per year increase the risk for asthma exacerbation. 12 canisters bought each year increases the risk of death from asthma.
You need to see your GP if the Blue Puffer is the only asthma medication you use or if you have asthma with poor control of symptoms with your current asthma plan. Poor symptom control is clear when you use your Blue Puffer more than twice per day, your activities are limited by asthma, and you have nighttime symptoms. If you have asthma and you don’t have an asthma plan, you also need to see your GP.
What your GP can do
It is important to have a regular health check for everyone. If you have had a chronic cough, wheeze or shortness of breath and use Ventolin over the counter and nothing else, this is especially important. Sometimes it might not be asthma.
If you are diagnosed with asthma, the test we use for asthma in general practice is spirometry. You might have triggers ranging from viral infections, cigarette/vaping, allergies such as house dust mite, mould, pollen and pets. Environmental triggers are also important. Indoor pollution can be from the gas cooktop or heater. Outdoor pollution can be from car pollution, industry and bushfires.
One of my patients with mild asthma who trained as a chef, had to leave his place of work as his asthma was triggered by all the gas cooktops.
GPs follow the Asthma Guidelines that simplify the treatment of asthma. Airway inflammation and narrowing can now be treated in one inhaled device. Combining the inhaled corticosteroids (ICS) and long-acting bronchodilator (LABA), the LABA acts as rapidly as Ventolin. The product is Symbicort and more products will enter the market with time.
We all have a role in reducing asthma deaths, minimising ED visits, and the burden of disease in our loved ones. This includes doctors, pharmacists, and the community.
Abbie and her brother Jacob are now on their new Symbicort action plan. Jacob is holding the Blue Puffer that was previously prescribed with his preventer separately. It is so much easier with one device.
