In this Issue April 2003

NAC Session - TSANZ Adelaide

TSANZ Primary Care Special Interest Group

World Asthma Day May 6

GP 3+ Education Program

Satellite Broadcast - 3+ Visit Plan

Severe Acute Respiratory Syndrome

Respiratory Disease in Primary Care 'The Way Forward'

GPCE 2003

Conference Diary 2003/4

National Asthma Council Session - TSANZ Adelaide

The National Asthma Council was delighted with the overall attendance at their session of the Annual Scientific Meeting of the Thoracic Society of Australia and New Zealand on April 8.

The NAC session themes were presented by an expert panel of speakers discussing inhaled corticosteroids (ICS) dosing levels and providing an update in emergency asthma.

The paediatric perspective on ICS prescribing was covered by NAC National Committee member Associate Professor Colin Robertson, who is Deputy Director of Respiratory Medicine at the Royal Children's Hospital in Melbourne. Fellow NAC National Committee member, Associate Professor Charles Mitchell, from the University of Queensland, examined the current data and evidence concerning ICS prescribing for adults.

For the view from primary care, the Chairman of the NAC's General Practitioners' Asthma Group, Dr H. John Fardy, a GP from Illawarra, covered the relevant facts and figures about ICS dosing. Additionally, Dr Fardy reviewed why GPs prescribe in the way they do and the process involved in how they access evidence about guidelines in their use of ICS.

The latest evidence and changes to treatment guidelines for acute asthma in children was also presented by Associate Professor Robertson, while Assoc. Professor Charles Mitchell reviewed new evidence, issues, and changes to treatment guidelines relating to adults.

Forthcoming NAC Newsletters will feature some of the presentations from the very successful NAC session.

TSANZ Primary Care Special Interest Group

Following the well-supported inaugural session of the Primary Care Special Interest Group at TSANZ, plans are already underway for the next 12 months activity.

Quality presentations from Dr H. John Fardy, Professor Justin Beilby, Associate Professor Nick Glasgow and Associate Professor Ian Charlton provided the basis for spirited group discussion addressing implementation of asthma guidelines.

Dr Fardy highlighted the contrast between specialist practice and primary care activities for respiratory patient presentation and how differences between the specialist and generalist view may arise.

Dr Tomlins, who convened the session as the RACGP representative to TSANZ, examined how the existence of excellent guidelines such the Asthma Management Handbook does not automatically lead to change in clinical practice. Evidence favours implementation as the key process and requires thoughtful planning on how the printed guidelines are actually applied in primary care.

In the coming year the Primary Care SIG intends to focus on researching the literature and preparing a distillation of implementation of guidelines in primary care, as well as building on the strong interest from primary care practitioners shown at TSANZ.

World Asthma Day May 6

The theme of World Asthma Day 2003 is the Burden of Asthma. The Global Initiative for Asthma (GINA ) has chosen the theme to raise awareness of the severe impact that asthma has on people's lives.

Look out for all the information and local Australian perspective from May 6 on the NAC Web Site.

GP 3+ Education Program

A-Team Activity Update

The NAC's Asthma 3+ Visit Plan Education Program, funded by the Department of Health and Ageing, is in full swing.

The A-Team presenters (doctors and health professionals who have been specially trained on the requirements for the Asthma 3+ Visit Plan and evidence-based best practice asthma management) are delivering the program nationally through meetings organised locally by Divisions of General Practice.

The presentation provides an overview of the Asthma 3+ initiative and can cover a range of topics tailored to specific needs and particular interests.

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Assessing severity
Spirometry
Medication Review/back titration
Written Asthma Action Plans
Patient Self-Management Education

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Addressing Barriers (to the third visit)
Helpful Resources
MBS claiming (PIP and SIP)
Practice systems (recall/reminder)
Information by visit (1-3+)

The national program is continuing to the end of May. Contact your local Division to find out about meetings in your area.

Satellite Broadcast - 3+ Visit Plan

The National Asthma Council's next program, Asthma 3+ Visit Plan, will screen live on the Rural Health Education Foundation satellite network on the evening of Tuesday 24 June 2003.

The Asthma 3+ Visit Plan, a best practice model of managing asthma, was originally developed by the National Asthma Council's General Practitioners' Asthma Group to assist GPs with planned asthma education and management within the normal consultation setting.

The Asthma 3+ Visit Plan involves at least three visits to the GP over a short period of four months for the sole purpose of improving the management of asthma. At least two of these visits to the GP should be planned in advance.

The visits incorporate:

diagnosis and assessment (including appropriate spirometry tests)
development of a written asthma management plan, and
patient education and review of asthma management plan.

The Asthma 3+ Visit Plan encourages partnerships in proactive asthma care between the patient and their health professionals.

For information on your nearest viewing venue in the Rural Health Satellite Network, contact the Rural Health Education Foundation on Ph: 1800 646 015 or Fax: 1800 555 501.

Rural Health Satellite Network

The program Asthma 3+ Visit Plan may be viewed live.

Severe Acute Respiratory Syndrome

The full impact of the Severe Acute Respiratory Syndrome (SARS) is still unknown. However, this severe pneumonitis due to a newly characterised Coronavirus may become one of the infections we will have to deal with regularly into the future.

The diagnosis of SARS is primarily based on symptoms of a respiratory tract infection and an appropriate travel or contact history. As the clinical presentation is very non specific molecular diagnostic tests are required to confirm cases.

So far (April 24), only four probable cases have been reported in Australia, three visiting Canadian children and a Queensland woman, all of whom have recovered with no transmission of the disease to other family members or close contacts.

The Thoracic Society of Australia and New Zealand (TSANZ) have released an interim statement on SARS. This Interim Statement will be updated when more definitive information becomes available.

Click here to go to the Statement on the Severe Acute Respiratory Syndrome from TSANZ

While there may be debate about effectiveness of masks in prevention of SARS, for example, attention to fundamental infection control measures such as hand washing is vital.

Excerpt from the TSANZ Statement re 'Use of Nebulisers' - April 29, 2003

A particularly severe breach of infection control occurred in Hong Kong related to the use of a nebuliser in a patient with SARS resulting in many infected staff and a number of deaths. When possible a spacer and pMDI should be used to deliver inhaled beta₂-agonist therapy. If nebulised therapy is required when possible it should be given in a negative pressure environment and health care staff should be aware of the high potential for transmission of the virus during and immediately after treatment.

Daily news releases and updates concerning SARS are available from the Australian Department of Health web site with excellent links to the most current guidelines for the public and the health professions.

Department of Health and the Ageing - Severe Acute Respiratory Syndrome

World Health Organization - Homepage

Centres for Disease Control, Atlanta - Homepage

Respiratory Disease in Primary Care 'The Way Forward'

Planning for the 2nd World International Primary Care Respiratory Group (IPCRG) Conference being held in Melbourne, Australia from the 19-22 February 2004 continues with registration and a call for abstracts opening on the IPCRG web site in early May. The organising committee is set to announce the Keynote Speakers who have been gathered 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:

Clinical Stream
Allergy and its diagnosis
COPD
Cough and Breathlessness
and more
People and Public Policy Stream
Complementary therapies
Lung Cancer
Rural models of respiratory care
Clinical acre in the Pacific Rim
and more
Practical Stream
Telemedicine
Asthma Action Plans
Respiratory nurses in primary care
and more

The conference venue is the Hotel Sofitel, in the heart of Melbourne. Full details about registration, accommodation and the social program will be available on the IPCRG web site early May.

IPCRG Melbourne 2004 Conference (www.ipcrg-melbourne.org)

GPCE 2003 Sydney 16-18 May

GPCE logo Preparation is well underway for the workshops on Paediatric asthma: diagnosis, management and the role of new therapies being presented by the National Asthma Council at GPCE next month.

Experienced GP presenters will provide the latest information on paediatric asthma in general practice covering

diagnosis,
severity assessment, and
medication choice.

There will be particular emphasis on starting, trialling or changing medications with the goals for good asthma management being

optimal asthma control,
fewest possible side-effects,
best possible lung function, and
enhanced adherence.

In all, the NAC will conduct nine workshop presentations at GPCE being held at the Sydney Showgrounds.

For more information and registration phone 1800 358 879 or 02 9211 7454 for a registration form or email GPCE2003@infosalons.com.au.

Useful Sites

GPCE 2003 Highlights

GPCE 2003

Conference Diary 2003/4

Submit brief conference/meeting details to the National Asthma Council for possible posting in our Conference Diary by email to nac@NationalAsthma.org.au.

The General Practitioners Conference & Exhibition 2003 The Sydney Showgrounds 16-18 May 2003 Paediatric asthma: diagnosis, management and the role of new therapies. GPCE 2003 Highlights GPCE 2003
National Asthma and Respiratory Educators Symposium 7 and 8 August 2003 University House' Australian National University Incorporating inaugural meeting of the Australian Asthma and Respiratory Educators Alliance. For more information contact Ken Langbridge: (02) 4320 3410 National Asthma and Respiratory Educators Symposium
The Australasian Society of Clinical Immunology & Allergy (ASCIA) 14th Annual Scientific Meeting Sheraton Towers Southgate & Sebel Lodge Hotel Yarra Valley, Melbourne, Australia October 10 - 13 2003 ASCIA Annual Scientific Meeting
2nd World IPCRG Conference Respiratory Disease in Primary Care 'The Way Forward' 19 - 22 February 2004 Hotel Sofitel, Melbourne, Australia IPCRG Melbourne 2004
The 2004 Australian Asthma Conference ‘A fresh breath – looking to the future’ 22 - 25 February 2004 Hotel Sofitel, Melbourne, Australia. Asthma Conference 2004