In this Issue October 2002

Asthma Management Handbook - References now online!

Printing the Asthma Management Handbook 2002

NAC Asthma 3+ Visit Plan GP Education Program

Asthma Management Handbook -
References now online!

Over the past several months the contributing authors to the Asthma Management Handbook 2002 (AMH 2002) have been working hard to finish the latest references for the publication.

The description of the AMH 2002 as a practical guide to clinicians, community pharmacists and other health professionals to assist them in their management of people with asthma is the driving force for our online reference system. The National Asthma Council believes that with the constant evolution of management philosophy, techniques and knowledge about asthma, the AMH 2002 will best serve as a "living" document.

The AMH 2002 recommendations are based on the most up-to-date evidence available, through:

the 1999 Evidence-Based Review of the Australian Six Step Asthma Management Plan (Coughlan J, Wilson A, Gibson P, NSW Health 2000),
subsequent Cochrane reviews and
other meta-analyses.

Where there is lack of evidence the consensus opinion of Australian experts has been incorporated.

As new evidence becomes available, changes to recommendations will be incorporated into the online AMH 2002 along with the appropriate reference(s).

Viewing the AMH 2002 References Online

The references are easily accessible throughout the AMH 2002 text. Each reference appears with a number and arrow (¹).

For example:

1. The reference appears in the text.

From the Asthma Management Handbook

The presence of other systemic hypersensitivity features may indicate the need for anaphylaxis management (adrenaline +/- volume expanders). Consider food allergy or reaction to medications or herbal remedies¹

2. The reference number is linked to the specific reference on the reference page. The citation for each reference is shown along with the level of evidence, based on the NSW Health Levels of Evidence outlined on page 13 of the Handbook and at NSW Health Levels of Evidence.

Ref No.	Title of reference (Click to view abstract)	Evidence
1	Huntley, A. and E. Ernst, Herbal medicines for asthma: a systematic review. Thorax, 2000. 55(11): p. 925-9. return to text	Level 1

3. An abstract of the reference, where available, can be opened in a pop-up window. Returning to the Asthma Management Handbook text can be achieved by clicking on return to text.

Huntley*, A. and E. Ernst (2000). "Herbal medicines for asthma: a systematic review." Thorax 55(11): 925-9. BACKGROUND: Asthma is one of the most common chronic diseases in modern society and there is increasing evidence to suggest that its incidence and severity are increasing. There is a high prevalence of usage of complementary medicine for asthma. Herbal preparations have been cited as the third most popular complementary treatment modality by British asthma sufferers. This study was undertaken to determine if there is any evidence for the clinical efficacy of herbal preparations for the treatment of asthma symptoms. METHODS: Four independent literature searches were performed on Medline, Pubmed, Cochrane Library, and Embase. Only randomised clinical trials were included. There were no restrictions on the language of publication. The data were extracted in a standardised, predefined manner and assessed critically. RESULTS: Seventeen randomised clinical trials were found, six of which concerned the use of traditional Chinese herbal medicine and eight described traditional Indian medicine, of which five investigated Tylophora indica. Three other randomised trials tested a Japanese Kampo medicine, marihuana, and dried ivy leaf extract. Nine of the 17 trials reported a clinically relevant improvement in lung function and/or symptom scores. CONCLUSIONS: No definitive evidence for any of the herbal preparations emerged. Considering the popularity of herbal medicine with asthma patients, there is urgent need for stringently designed clinically relevant randomised clinical trials for herbal preparations in the treatment of asthma.

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For the full reference list go to

Asthma Management Handbook References

Printing the Asthma Management Handbook 2002

The Asthma Management Handbook 2002 is now available in a printer friendly format. At the top of each page a printer icon has been added. Click on this icon to go to the Printer Page. Here you can download and print the handbook in full*. Also, we have selected some popular pages that can be easily downloaded for print such as

Asthma Action Plans for Young People,
Asthma Action Plans for Adults,
Asthma First Aid Chart,
Asthma Medical History Checklist,
Patient Education Checklist, and
Respiratory Function Tables.

Included in the full print version of the handbook are all the current references which will be updated as new references become applicable.

Printer friendly version of the Asthma Management Handbook 2002

*Adobe Acrobat Reader is required to view and print these files. You can obtain a free copy from Adobe by clicking the Acrobat Reader icon.

Feedback to the National Asthma Council

The National Asthma Council appreciates your support. We value your opinion and comments about our publications and information contained here on the web site.

Should you wish to make a comment about a topic or information relating to asthma please do so by going to the Feedback section of the web site.

Occasionally, the NAC seeks your specific comment with regard to the web site format and function. Any time you take to complete feedback or questionnaires is well appreciated.

We look forward to your continuing support and feedback into the future.

For comment and feedback

NAC Asthma 3+ Visit Plan GP Education Program

A-Teams Project and A-Teams National Training Day

The National Asthma Council's Asthma 3+ Visit Plan Education Program funded by the Department of Health and Ageing, involves the training and support of expert asthma presenters (A-Teams) who will be available as resources to Divisions of General Practice.

Divisions of General Practice and the State Based Organisations of Divisions will be able to utilise these A-Teams for workshops and presentations for general practitioners and practice nurses on the requirements for the Asthma 3+ Visit Plan and also about evidence-based best practice asthma management.

A-Teams have been set up in Queensland, New South Wales (to cover ACT), Victoria (to cover Tasmania), South Australia (to cover the Northern Territory) and Western Australia. Each 'A Team' consists of 4 GPs, 1-2 respiratory physicians and 2-3 asthma educators.

A national training day to support the A-Teams was held on 17th October, in Sydney. The main focus for the incredibly full day was to refine a presentation kit that could be used for all speakers to provide national consistency for the workshops.

Other areas covered on the day were:

the role of Divisions of General Practice in relation to supporting GPs to manage chronic illness;
the new MBS items - how they work and what is required to claim them;
barriers to implementing the 3+ Visit Plan: the general practice perspective; and
adult learning techniques.

The day was very successful with forty-five participants attending mostly from interstate. The energy and enthusiasm was high and a great deal of information was covered. With the much appreciated involvement of A-Team members, the standard presentation developed is flexible both in content and mode of delivery.

If you would like more information on the National Training Day or the A-Teams project, please call the National Coordinator, Ms Darlene Henning on 03 9214 1422.

ALF - COPD Guidelines

ALF logo The diagnosis of asthma in some patients, particularly patients with increasing age, may be complicated by the development or existence of chronic obstructive pulmonary disease (COPD).

The major contributing factor to COPD in adults is smoking and the condition is already a significant burden on communities world wide and is Australia's fourth leading cause of burden of disease.

The Australian Lung Foundation (ALF) is committed to improving standards of care for people with all types of respiratory conditions with efforts currently focused on COPD. The ALF and the Thoracic Society of Australia and New Zealand, together with other stakeholder organisations, have developed the Chronic Obstructive Pulmonary Disease (COPD) Australian and New Zealand Management Guidelines and the COPD Handbook. The evidence-based document has been written with the GP and a primary care focus very much in mind.

With the COPD handbook in its final draft form it is now being readied for publication in November to coincide with the first annual World COPD Day (see September Newsletter 7). The theme, “Raising COPD Awareness Worldwide”, will be the start of an ongoing campaign to make the public more aware of COPD.

Awareness is the focus because worldwide data suggests that an astonishing number of people, including health care professionals, are unfamiliar with COPD.

For more information go to the Australian Lung Foundation
COPD Guidelines & Handbook - Consultation Draft - July 2002*

*Adobe Acrobat Reader is required to view this file. You can obtain a free copy from Adobe by clicking the Acrobat Reader icon.

Melbourne GPCE Workshops

The popular General Practitioner Conference & Exhibition (GPCE) is taking place in Melbourne for the first time from 15-17 November.

GPCE specifically tries to provide and cater for the needs of General Practitioners and the organisers have enlisted the University of Melbourne to help conduct the excellent Scientific Program. Along with the interactive and practical workshops, there will be a quality trade exhibition for equipment, computers, patient aids, pharmaceutical updates.

As for the Sydney GPCE held earlier this year in May, the National Asthma Council will run a series of workshops on the 3+ Visit Plan and lung function testing over the three days.

Members of the NAC's GP Asthma Group will share their experience and practical knowledge of the 3+ Visit Plan and how this proactive asthma care plan can be woven into every day practice activities. Similarly, with spirometry set to become essential practice equipment, the GP presenters will explain techniques and interpretation and how to make spirometry work effectively in your practice.

The 3+ Visit Plan is a Commonwealth Government funded national GP Asthma Initiative based on the NAC's 3+ Visit Plan that provides a GP-friendly framework for proactive education and review of moderate to severe asthma patients over 3 or more visits.

GPCE Melbourne web site

IPCRG and Asthma Australia Conference

Start your planning now!

IPCRG logo The 2nd World International Primary Care Respiratory Group (IPCRG) Conference will be held in beautiful Melbourne, Australia from the 19-22 February 2004. Planning for the IPCRG meeting is well underway with the organising committee set to announce a variety of speakers from Europe, Australia, New Zealand and the Asia-Pacific region.

The keynote plenary sessions, together with symposia and practical skills workshops will cover themes and topics including:

proactive care in health professional asthma management
patient education and adherence
improving patient care and education through networking
evidence-based best practice in respiratory care
expanding health professional education through Information Technology
practical applications including spirometry, skin prick testing and more.

The conference venue is the magnificent Hotel Sofitel, in the heart of Melbourne.

Following on immediately after the IPCRG meeting is the 2004 Australian Asthma Conference at the Hotel Sofitel, from Sunday 22 to Tuesday 24 February 2004.

The Asthma Conference will explore the theme ‘A fresh breath – looking to the future’. The keynote plenary sessions, workshops and symposia with speakers from Australia and overseas, will explore all aspects of the theme including:

new directions in research
living and working with asthma
an holistic approach to asthma care
differing approaches to asthma management and care
asthma management in a multicultural community
the role of the community in asthma management

The 2004 Conference will provide the opportunity for participants to network with leading researchers and practitioners and will be ideal for all people involved in the care and management of people with asthma:

asthma educators,
practice and respiratory nurses,
community health workers,
general practitioners,
pharmacists, and
researchers.

Indeed those who deal with asthma will benefit from being a part of this informative and interactive conference.

Keep up to date with all the conference news by visiting the conference web sites at:

IPCRG Melbourne 2004 Conference

Asthma Australia Conference 2004

Created October 22, 2002