In this Issue May 2003

Written Asthma Action Plans

Since the inception of the National Asthma Council, Australia in 1990, the number of deaths from asthma has fallen from 964 in 1989 to 422 in 2001 (latest figures available). While the number of deaths (1 in 250) due to asthma is relatively low compared with other conditions, many asthma deaths are preventable. Suboptimal medical care and a lack of information means that people continue to die needlessly from the condition.

The recent study by Associate Professor David H Wilson and colleagues in South Australia "Prevalence of asthma and asthma action plans in South Australia: population surveys from 1990 to 2001" published in the 19 May edition of the Medical Journal of Australia, highlights an increased burden of asthma in Australia.

The study also showed that there is room for improvement with the use of written Asthma Action Plans as a tool for each individual patient. Importantly, there is clear evidence that the written Asthma Action Plan is an effective educational tool in improving health outcomes (Asthma Management Handbook 2002 - Level 1 evidence).  

Points to Note 

• Most people can safely increase their treatment at home. 

• Those prone to sudden severe attacks should go to hospital at the first sign of deterioration. 

• In children, symptom-based plans are preferred. 

One year on: The Asthma 3+ Visit Plan - Satellite Broadcast 24 June 

Sponsored by The National Asthma Council with a grant from the Department of Health and Ageing, the program provides an outline of the Asthma 3+ Visit Plan, including

• An update on its current status and the views of general practitioners

• Provide information on asthma diagnosis, assessment of severity and management of asthma 

• Explain the correct use of appropriate devices 

• Discuss the use of spirometry in asthma diagnosis and monitoring

• Discuss back titration and issues relating to the maximum safe doses of inhaled steroid 

• Provide practical advice to health professionals to increase their understanding of how to complete a written asthma action plan 

• The role pharmacists play in the 3+ Visit Plan 

• Tips and practical advice for implementing the Asthma 3+ Visit Plan 

Panel of Speakers 

• Chair: Dr Norman Swan, Presenter of the Health Report on ABC Radio National, 

• Dr Amanda Barnard, General Practitioner, Claremont, WA 

• Dr Simon Bowler, Respiratory Physician, Mater Medical Centre, South Brisbane, QLD 

• Mr Stephen Hughes, Community Pharmacist, Rouse Hill, NSW

How can you watch this program?

Live at a Rural Health Satellite Network site on Tuesday 24 June 

Repeated at a Rural Health Satellite Network site on Friday 27 June 

On Video and the Internet

For information on videos and your nearest viewing venue in the Rural Health Satellite Network, contact the Rural Health Education Foundation on Ph: (02) 6232 5480 or Fax: (02) 6232 5484 or visit their website (see below). It is important to register first to ensure venues are open on the night. Please register through the Foundation.

Satellite Television Broadcast Times - Tuesday 24 June 2003

8.00pm Eastern Standard Time in on Channel 4 ACT, NSW, QLD, TAS & VIC 

7.30pm Central Standard Time on Channel 4 in SA and NT 

6.00pm Western Time on Channel 4 and repeated at 8.00pm Western Time in WA

Repeat of Programme

If you cannot view this program on broadcast day, it will be repeated on decoder Channel 23 on Friday 27 June at 

12.30pm in ACT, NSW, QLD, VIC & TAS, 

12.00pm in SA & NT, and 

10.30am Western Time in WA

Useful Information

The program Asthma 3+ Visit Plan may be viewed live or at a later date by logging onto the Rural Health Education Foundation's web-site and clicking the icon video-streaming.

Rural Health Satellite Network

Rural Health Education Foundation Video Streaming

Heading into Winter - Colds and Influenza

The international attention placed on Severe Acute Respiratory Syndrome (SARS) may have deflected the vigilance needed with regard to obtaining influenza vaccine for those in a high risk category. 

Influenza vaccination is currently recommended for all who want it and is particularly recommended for

• children 6 months and older with severe asthma (frequent asthma attacks or regular hospital admissions) 

• teenagers with severe asthma

• adults with severe asthma 

• pregnant women with severe asthma or women with asthma who anticipate being pregnant through the winter. In this case, it is wise to be vaccinated before the pregnancy.

The influenza vaccine takes about 14 days to provide its greatest protection so talk to your doctor about the value of being vaccinated. 

People aged 65 and over receive the vaccine free.
 

Preventing Colds and Influenza. 

Common colds are quite different to influenza, which is a more serious illness that can cause the whole body to ache and often makes you sick enough to go to bed. Common colds mostly only affect the nose and throat. 

Droplets of fluid from your nose or mouth spread cold and influenza viruses to other people. To prevent this transfer:

• keep your hands away from your eyes, nose, and mouth

• use paper tissues to blow your nose and throw them away after use

• wash your hands thoroughly with soap after blowing your nose, after covering your mouth for a cough or sneeze, and before preparing or eating food

• do not share cups or cutlery with other people (especially if they are showing cold or 'flu symptoms)

Managing Colds and Influenza

First and most important stick with your written Asthma Action Plan. (If you are a person with asthma and you do not have a written Asthma Action Plan, please discuss this with your doctor next time you visit.) Get plenty of rest to help your body's immune system fight off the viruses and 

• drink plenty of fluids to replace fluids lost from your body,

• avoid smoking or exposure to cigarette smoke,

• use medication to relieve aches and pains, and reduce fever,

• inhale steam to clear blocked sinuses and ease chest tightness in adults,

• use saline nasal sprays to help clear mucus,

• a decongestant, in the form of nasal spray, drops, tablets, or mixture, may help dry a runny nose or relieve blocked sinuses,

• suck ice or throat lozenges, or gargle warm, salty water to help soothe a sore throat.

Your doctor can assess the severity of your illness, provide information about its expected duration, and advise you on treatment and help you to better manage your asthma through the illness. 

It is especially important you consult your doctor if symptoms are severe, if they persist, or you develop severe headache, difficulty in waking up, a high fever, or if light hurts your eyes.

For more information see 
Asthma & Influenza - The Facts

Asthma and where you live in Australia

One of the questions most frequently asked of the National Asthma Council concerns the best location to live in Australia if you have asthma.

Asthma prevalence around the nation is pretty much the same for all states and territories, but is perhaps slightly higher in rural areas than urban. It is very much dependent on the local allergens - pollens, grasses, moulds, house dust mite, and so on. 

Coastal cities tend to have higher dust mite levels, particularly if they have humid climates, and inland regions, while drier and with lower dust mite levels, have many types of pollens and moulds that can trigger asthma. 

When deciding where to live, it may be best to consider what in particular triggers your asthma.

Local flare-ups in asthma symptoms can occur, usually seasonally, when pollens are released and high humidity or thunderstorms cause pollen granules to burst and provoke asthma attacks. 

Precautions can be taken to make your house 'asthma-friendly': such as

• Encase mattress and pillows in mite-proof covers. Your pharmacist can advise on this. 

• Wash bedclothes weekly in hot water (over 55°). 

• Shake and air pillows and quilts in the sun weekly. 

• Use synthetic or wool doonas or quilts rather than feathers or down. 

• Remove soft furry toys and soft furnishings, if possible. Soft toys can be placed in the freezer overnight to kill dust mites. 

• Helpful suggestions for cleaning: 
  - wear a mask 
  - dust with a damp cloth or electrostatic duster 
  - wet-mop rather than vacuum or use an electrostatic mop 
  - consider ducted or well-filtered vacuum-cleaning systems.

For more information see 

Asthma & Allergy

The Traveller with Asthma

IPCRG 'The Way Forward' Update

Emergency Management of Asthma Chart - for Hospitals

The Emergency Management of Asthma Chart has been updated. Copies for Accident and Emergency Departments will be available from the middle of June.

For information on how to order a chart for your Accident and Emergency area go to 

Emergency Management  of Asthma Chart