In this Issue January 2005

Diagnosis and Treatment of Allergy and Asthma

Allergic Rhinitis and Asthma

Pregnancy and Asthma

Research Funding Opportunities 

Conference Diary 2005

Diagnosis and Treatment of Allergy and Asthma

Complementary health care in Australia also involves allergy and asthma management. In addition to complementary medicines and therapies, there are a number of unconventional tests that have been advocated in the diagnosis and treatment of allergy, asthma and immune disorders.

The Cochrane Collaboration has reviewed some complementary therapies for asthma but there is currently limited evidence to make a recommendation on their use (based on the selection criteria used by the Cochrane review).

The Australasian Society of Clinical Immunology and Allergy (ASCIA) has recently released a position paper examining several unorthodox techniques that claim to be useful in the diagnosis and treatment of allergy, asthma and immune disorders.

For people seeking tests and treatments that may help their conditions, treatment based on inaccurate, false positive or clinically irrelevant results may simply mislead, or even lead to ineffective and at times expensive treatments, delaying more effective therapy. Occasionally, harm may result, such as from unnecessary dietary restrictions, particularly important in growing children.

Importantly, claims of being able to "cure" food allergies have potentially dangerous consequences for those with true life-threatening reactions.

Whilst there are currently no "cures" for allergy, asthma and immune diseases, accurate and scientifically validated tests and effective treatments are available, enabling most people with allergies and asthma to lead normal, active lives.

Useful Resources

ASCIA Position Statement
'Unorthodox techniques for the diagnosis and treatment of allergy and asthma'
http://www.allergy.org.au/pospapers/unorthodox.htm

AMH 2002 Complementary therapies for asthma management  

AMH 2002 Other Medications and Asthma

For more information on allergies go to
Australasian Society of Clinical Immunology and Allergy 

Allergic Rhinitis and Asthma

Many people who have suffered with allergic rhinitis will confirm that it is not just a trivial complaint. Indeed it is one of the most prevalent medical conditions and has significant effects on quality of life.

Associate Professor R S Walls, from the Department of Immunology and Allergy at Concord Hospital, NSW and colleagues from around the country, recently reviewed the management of allergic rhinitis from an Australian perspective. They found that the prevalence of all allergic diseases, including allergic rhinitis, has increased dramatically over the past few decades, particularly in developed countries.

The prevalence of hayfever in one Tasmania study was shown to have doubled, rising from 19.2% in 1968 to 41.3% in 1991–1993.

As many people with asthma already know allergic rhinitis and asthma frequently co-exist, with allergic rhinitis being a significant risk factor for asthma. There is evidence to show that treating allergic rhinitis particularly with intranasal corticosteroids, can reduce asthma-related emergency department visits and hospitalisations.

The past few years have seen changes to the scheduling of drugs used in the treatment of allergic rhinitis with beclomethasone, budesonide, mometasone and fluticasone now available over the counter (OTC). The article reviews the variety of antihistamines and intranasal corticosteroids available for people to self-select and discusses the pharmacotherapeutic options for allergic rhinitis in children.

While pharmacy may become the focal point for initiation of treatment for many people, the authors stress the need for a continued team approach in management, particularly when a person has a condition that is unresponsive to OTC treatments.

Go to article

Optimising the management of allergic rhinitis: an Australian perspective

http://www.mja.com.au/public/issues/182_01_030105/wal10248_fm.html

Pregnancy and Asthma

The National Asthma Council is an information partner of the popular Better Health Channel website. Statistics from that website show that articles on pregnancy are consistently in the top ten pages accessed on this very busy site.

These topics include:

1. Pregnancy - signs and symptoms.

2. Pregnancy - week by week.

3. Pregnancy and diet.

With one in ten adults having asthma, there will be a significant number of women with asthma who are pregnant or perhaps trying to become pregnant.

Earlier this month, the USA National Asthma Education and Prevention Program published guidelines “Managing Asthma During Pregnancy: Recommendations for Pharmacologic Treatment—Update 2004 (EPR—Update 2004)” (http://www.nhlbi.nih.gov/health/prof/lung/asthma/astpreg.htm).

Some of the points highlighted for the release of these updated USA guidelines are universally applicable.

• Controlling asthma during pregnancy is important for the health and wellbeing of the mother as well as for the healthy development of the unborn baby.

• For some women with mild asthma their asthma may worsen during the pregnancy while for other women it may improve.

• Pregnant women should have their reliever medication available at all times.

• If preventer treatment with inhaled corticosteroids was needed prior to the pregnancy, it should be continued.

• Other important aspects of asthma management during pregnancy include identifying and limiting exposure to asthma triggers.

• Addressing other conditions that can worsen asthma during pregnancy, such as allergic rhinitis, sinusitis, and gastroesophageal reflux, is important.

Overall, well-controlled asthma is rarely affected adversely by pregnancy. Some women deteriorate, some improve, and some stay unchanged. Good asthma management, including a written Asthma Action Plan, should cope with any exacerbation.

Useful Australian Resources

Better Health Channel
http://www.betterhealth.vic.gov.au/

Pregnancy and Asthma
http://www.nationalasthma.org.au/html/management/spec_topics/st006_preg.asp
 

Asthma Action Plans 
http://www.nationalasthma.org.au/html/management/action/index.asp

For more information or support, contact your local Asthma Foundation on 1800 645 130.
 

Asthma Foundations of Australia

Asthma Foundation of the ACT

Asthma Foundation of New South Wales 

Asthma Foundation of Northern Territory 

Asthma Foundation of Queensland

Asthma Foundation of South Australia 

Asthma Foundation of Tasmania

Asthma Foundation of Victoria 

Asthma Foundation of Western Australia 

Research Funding Opportunities