Call to do better in non-drug asthma management

asthmaManagement of adult asthma is still below par in Australia with a minority of patients receiving a written Asthma Action Plan, regular review or a doctor checking their inhaler technique.

The findings, from an analysis of the Tasmanian Longitudinal Health Study cohort at age 49 years, suggest implementation of best practice remains a challenge.

The study, of more than 800 participants, found 15.6% had current asthma ranging from infrequent symptoms (51.2%) to mild persistent asthma (23.0%) and moderate-to-severe asthma (25.8%).

Only 17.9% of participants had a written Asthma Action Plan while just over half (53.8%) had a verbal action plan. Only one-third of plans had been reviewed or received in the previous 12 months.

The study also found that despite persistent symptoms, only 37.9% of adults with asthma had discussed their asthma with a GP in the previous 12 months.

Less than half (42.7%) had a doctor assess their inhaler technique although most (82.7%) had received some education about the correct use of inhalers.

The researchers said modifiable risk factors should be addressed as a priority before any escalation of pharmacological therapy for asthma.

“Inappropriate inhaler technique remains a common obstacle to asthma control and is associated with increased risks of asthma exacerbations and hospital admissions,” the study said.

There was also a 20% rate of smoking amongst participants with persistent asthma symptoms.

“Despite the plethora of data in favour of non-pharmacological asthma management, implementation remains a challenge in Australia and worldwide. Numerous barriers exist, including patient-related, doctor-related, cultural and economic factors.”

And while there had been some success with educational programs and financial incentives provided to primary care health professionals, clearly more needed to be done.

“Moving forward, a greater focus should be placed on the involvement of non-medical health professionals in community-based asthma management,” the study authors said.

The findings are published in the Journal of Asthma.

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