Women and elderly feature in rising asthma death toll

Asthma

By Mardi Chapman

19 Nov 2020

Dr Jonathan Burdon

The latest data from the Australian Bureau of Statistics shows a persistent and unacceptable number of asthma-related deaths each year, many of which should be preventable.

The data, commissioned by the National Asthma Council Australia, showed there were 421 asthma-related deaths – 272 females and 149 males – recorded in Australia in 2019 .

The 6.5% overall increase in asthma mortality from 2018 was led by more female than male deaths. Almost half of the female deaths were in women aged under 54 years.

Respiratory physician and Asthma Council spokesperson, Dr Jonathan Burdon told the limbic that women were still at a higher risk than men of dying from asthma in Australia.

“We don’t quite know why women are overrepresented in the mortality rate. That’s a bit of a conundrum and in fact we don’t know why a lot of these deaths are happening.”

“Why women? I’ve always theorised that particularly in the younger age group that women in their 40s and 50 s are often at the peak of their family time and their careers and I think that what happens – and this doesn’t just apply to women with asthma – is they tend to put themselves last when sometimes first is okay.”

“I wouldn’t be critical, it’s just that regular medication is meant to be taken regularly.”

The ABS data also showed asthma-related deaths were on the rise for all Australians aged over 75 years. The 264 deaths in >75 year-olds represented almost two thirds of all asthma-related deaths .

“In the older age group I think that not only is it forgetting to take your medication but physical disability – if your hands are very arthritic then you may have trouble using your inhaler. There have been lots of improvements in inhaler technology but it’s a potential issue.”

He said costs of care and not going to their GP or treating asthma specialist for a regular review were other possible issues.

Plus some older people simply accept reduced lung capacity as a natural part of getting older.

“We do know that about 40% of people prescribed preventive medication for their asthma in Australia don’t take it regularly. We know they are overrepresented in the admissions to hospital and mortality rates,” he said.

“When everybody who is prescribed regular medication takes that regularly then I am sure we will see a big drop. We will never get deaths down to zero ….but I think it is possible to improve the numbers significantly.”

Dr Burdon said clinicians had to keep on keeping on – ensuring their patients understood their asthma, what each of their medications were for, and what to do if their asthma was getting worse.

And that education process was probably best done by specialists who might have more time in their consultation than GPs.

However he emphasised that asthma deaths do not just occur in the population of people with severe or difficult to control asthma that specialists typically see.

“We do know that people with mild asthma may die from it and that usually occurs if they have difficulty getting medical attention, for example in the thunderstorm epidemic four years ago when ambulances were completely swamped. The system was just overwhelmed and some people died because they couldn’t get to hospital.”

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