In this Issue November 2006

Asthma Management Handbook Launch

  The Hon. Christopher Pyne

  Ms Kristine Whorlow

  Professor John Wilson

  Professor Justin Beilby

Asthma Management Handbook Launch Function

Online version Asthma Management Handbook 2006

Dementia and Physical Co-morbidity

Seeking consumer applications - HealthConnect SA

Research Funding Opportunities 

Conference Diary 2006

Asthma Management Handbook Launch

New asthma management guidelines for Australia were launched on November 14 by The Hon. Christopher Pyne, Parliamentary Secretary for the Minister for Health and Ageing.

The asthma management guidelines, published as the National Asthma Council Australia’s Asthma Management Handbook, are the gold standard of practice for asthma management in Australia.

They are updated regularly to accommodate changes in asthma management, based on the latest medical evidence, and new treatments that become available as well as reflecting current areas of consumer concern.

For the first time the Asthma Management Handbook 2006 highlights the link between asthma and depression and tackles the growing trend towards complementary therapies, warning that popular ‘remedies’ such as echinacea and royal jelly may cause life-threatening anaphylaxis in allergic individuals with asthma.

The Handbook also contains information on new drug therapies and their changing role and there is an emphasis on practical interventions for asthma that work, including stopping smoking, losing weight and matching the inhaler device with the capability of the patient.

Copies of the new Asthma Management Handbook will be delivered nationally to all GPs, pharmacists and other health professionals who manage asthma in coming weeks, and copies will be made available to medical and pharmacy schools for their students for the next few years.

Below are edited presentations from the launch.

The Hon. Christopher Pyne, Parliamentary Secretary for the Minister for Health and Ageing.

Kristine Whorlow CEO, National Asthma Council Australia

Professor John Wilson, Chairman, National Asthma Council Australia

Professor Justin Beilby, Chairman Guidelines Committee

The Hon. Christopher Pyne

Parliamentary Secretary for the Minister for Health and Ageing

Speaking while officially launching the new Asthma Management Handbook, Mr Pyne said the National Asthma Council Australia compiled the first management handbook in 1990, as part of its role to ensure a national approach to the illness, and had since kept it up to date.

“More than 60 experts in this field have created this new edition by reviewing the latest research, assigning levels of evidence, writing, rewriting and editing - all in their ‘spare’ time,” Mr Pyne said.

“This very generous collaboration has made Australia an international model in terms of our approach to asthma. It has ensured that our asthma management guidelines are not only authoritative, but they are being used by GPs, in particular.

“The results can be seen in our success in treating asthma. Although it remains a very real problem for this country, asthma deaths have dropped from a peak of 964 in 1989 to the latest statistic of 311, recorded in 2004.”

Mr Pyne said approximately 2.2 million Australians were affected by asthma. Up to 16 per cent of children and 12 per cent of adults had a current diagnosis of asthma.

The Government provided $103,000 under the Asthma Management Program to fund the printing of 80,000 copies of the new edition, which will be distributed principally to respiratory, paediatric and general physicians, allergists, general practitioners, pharmacists, nurses, asthma foundations, asthma educators, students and other allied health professionals.

Ms Kristine Whorlow

CEO, National Asthma Council Australia

Even if you don’t have it yourself, you will know someone who does and I’m sure you’re all only too aware of the devastating toll asthma can take.

Too many people have it and too many people are still dying from it. Thankfully we are learning how to manage it better all the time.

Behind the scenes, the team at the National Asthma Council Australia, lead by the unflappable Kathy Hope, has literally worked miracles to get the Handbook finalised and printed. Well done and thank you.

More than 80,000 copies of the Handbook will be printed, thanks to support and funding from the Department of Health and Ageing.

And we are extremely fortunate to have The Hon. Christopher Pyne with us to represent the Australian Government and to officially launch the new asthma treatment guidelines for Australia.

Mr Pyne – your personal and professional commitment to asthma education in Australia is well known and we are particularly pleased that you could join us today to officially launch the Asthma Management Handbook.

Professor John Wilson

Chairman, National Asthma Council Australia

All of us wish that we weren’t here today. All of us wish that there wasn’t a problem with asthma – but there still is and we’re still here.

We’re here because we’re committed to solving the asthma problem. And that’s been the single goal of the National Asthma Council Australia since it was formed in the late 1980s in response to the then high asthma mortality rate, increasing prevalence of asthma and a corresponding media and public outcry.

When it was formed, its role - which has never changed - was to ensure national co-ordination on asthma treatment, education and promotion.

As Australia’s peak asthma body, the National Asthma Council is a successful collaboration of the Thoracic Society of Australia and New Zealand, The Royal Australian College of General Practitioners, the Pharmaceutical Society of Australia, Asthma Foundations of Australia and the Australasian Society of Clinical Immunology and Allergy.

It also works with other organisations and individual experts to achieve its aims.

We’ve had a marked impact. Surveys show us that GPs and pharmacists manage asthma better and that people with asthma have improved asthma management practices too – but there’s still a lot of work to be done.

Our collaborative approach led to asthma becoming a National Health Priority and this Australian Government commitment, has enabled many important programs to take place. With the established asthma treatment guidelines in place, we’ve all been confident in our asthma management messages and practices.

But we all know that there are still people with asthma whose asthma management practices are not optimal.

So, how do we continue to improve the asthma situation in Australia?

The answer lies in the consistent use of evidence-based medicine.

A major role for the National Asthma Council Australia is producing evidence-based information for health professionals who treat people with asthma – notably; it produces the national treatment guidelines for asthma, the Asthma Management Handbook, which is, of course, what we are here to launch today.

When the Australian treatment guidelines for asthma were originally published in 1989 they were the first national treatment guidelines for asthma published anywhere in the world.

Since then, the mortality rate has decreased significantly, as have emergency department attendances, intensive care admissions and hospital bed days directly related to asthma, reflecting the intense and ongoing effort of the National Asthma Council to implement the asthma guidelines through a variety of asthma educational activities.

The Asthma Management Handbook is the second most widely read medical guidelines in Australia and it has also been adapted for use overseas.

Many of our neighbouring Asia Pacific countries have been pleased to have access to the Handbook and are using it as a base from which to develop their own guidelines that reflect local conditions, regulatory process, health systems, culture and economic circumstances.

And that is the key to successful guidelines – they must be appropriate for the country and time in which they are to be implemented.

The Asthma Management Handbook is developed by Australian practitioners for Australian practitioners. And in preparation for this 6th edition, we not only conducted our usual consultations with all user groups but surveyed the main one, GPs, to find out what they wanted from their guidelines.

Hard copies will be made extensively available – thanks to generous funding from the Department of Health and Ageing which has sponsored the printing.

And the Handbook will also continue to be available in its much accessed online edition

Government, individuals, industry and professional societies have all played an important role in contributing to, and reviewing, the content. So much support, involvement and collaboration results in a strong sense of national ownership of the Asthma Management Handbook, which is a major contributing factor to the success of its implementation and will, I believe, continue to be so.

We must remember however that, beyond the guidelines themselves, there is still much to be done to manage asthma effectively in Australia.

The launch of the Asthma Management Handbook 2006 is not the culmination of our work. Rather, it is a timely opportunity to re-focus ourselves and take the fight against asthma forward, with the Handbook as our guide.

Thank you to all who have helped the new asthma treatment guidelines for Australia see the light of day – in particular, I would like to acknowledge the work of the Guidelines Committee, chaired by Prof Justin Beilby and invite him to provide you with a sneak preview of what’s inside the new Asthma Management Handbook.

Professor Justin Beilby

Chairman, Guidelines Committee

Today marks the culmination of an extraordinary effort by an extraordinary group of people – many of whom are gathered here in this room.

The Asthma Management Handbook is155 pages of the best available medical evidence that will guide Australian health professionals in their care of the 2.2 million Australians with asthma.

While it may not be the stuff that best sellers are made of, the fact is the Asthma Management Handbook 2006 will have a circulation that will rival most mainstream non-fiction new releases.

It will be read and re-read. And, it will save lives.

For those of us who have been closely involved in the evolution of this edition, it’s been a long gestation - 34 months in the making, beginning in earnest in January 2004 when the National Asthma Council Australia surveyed GPs about their preferences for the next version of the Handbook.

The results of that national survey confirmed that GPs – who are the main user group for the Handbook - still wanted a hard copy publication as well as a web version, and that they sought more information on issues such as allergy in asthma, comorbidities, combination therapies, and systematic care.

In June 2004, the National Asthma Council convened a multidisciplinary steering committee of experts drawn from its member bodies and from the Australian Asthma and Respiratory Educators’ Association.

And then the work really began.

The Guidelines Committee oversaw the work of small ‘chapter working groups’, each with at least two specialists and two GPs to maintain the focus on primary care and practicality.

A modified SIGN (Scottish Intercollegiate Guidelines Network) process was used: working group leaders assessed the evidence and drafted the text, which was then reviewed by other working group members. Additional experts were invited to contribute in particular areas.

All chapters of the Handbook were internally peer-reviewed among the large group of contributors, and by a representative of the Royal Australian College of General Practitioners as our ‘first GP reader’.

The complete draft was then circulated to asthma stakeholder groups, including the National Asthma Council’s member bodies, other professional organisations, and the pharmaceutical industry. All comments received were reviewed by the chapter working groups, and by the Guidelines Committee where required, before final amendments were made to the text.

And the edits have literally been made up until the 11th hour ensuring the Handbook that The Hon Christopher Pyne will be launching shortly is as up to date as possible.

As with previous editions, the new edition of the Asthma Management Handbook aims to help clinicians and other health professionals make changes in their practice based on sound evidence.

The Handbook acknowledges the difficulties of providing organised care in the primary care setting and tries to provide practical strategies that will assist with diagnosis, ongoing management and patient education.

And it addresses the areas suggested by GPs in that initial survey conducted 34 months ago.

There is information on new drug therapies and their changing role, especially combination therapy with an inhaled corticosteroid and a long-acting beta agonist.

Emphasis is placed on practical interventions that work, including smoking cessation, weight reduction and matching inhaler device with patient capability.

Attention is also drawn to the diagnosis and treatment of comorbidities including COPD, depression and sleep apnoea, as well as the management of allergic conditions, particularly rhinitis. A new chapter on asthma and complementary therapies has been included.

The new Handbook follows the successful format of earlier editions, presenting the best available evidence in a clear, concise format and where evidence is lacking, it incorporates the consensus opinion of national experts, something not achievable in many other countries.

The 155 pages that are the Asthma Management Handbook 2006 represent an amazing effort by over 60 volunteer experts to make the very best available evidence as accessible as possible.

On behalf of the Guidelines Committee, thank you to everyone who played a part in the birth of the publication – and thank you to the countless clinicians Australia-wide who will use the information within to improve the health and wellbeing of so many Australians.

Asthma Management Handbook Launch Function

Online version Asthma Management Handbook 2006

The Asthma Management Handbook is the leading destination of the National Asthma Council’s website representing 20 per cent of the 1.2 million plus pages viewed each year. The online Asthma Management Handbook 2006 carries the full references and levels of evidence supporting the content.

Throughout the chapters there are relevant internal and external links and a Handbook-only search function to assist you in finding specific information.

Most importantly, the online Asthma Management Handbook will be updated appropriately to reflect changes in our understanding and management of asthma. If you would like to be notified of changes and updates you can register online for that service.

Some areas of interest from the Asthma Management Handbook 2006 include:

AMH 2006 Home Page

Acute asthma managing adults - Initial assessment

Acute asthma managing adults - Treatment

Acute asthma in children - Initial assessment

Acute asthma in children - Treatment

Asthma Action Plans - Rationale

Asthma Action Plan - Template

Asthma history checklist for new patients

Self-management education checklist

Organising your practice for effective asthma management

Relievers

Preventers

Symptom controllers

Combination medications

Other medications

Delivery devices

Dementia and Physical Co-morbidity

The Asthma Management Handbook 2006 recognises the importance of comorbidities in the management of the patient with asthma. Accordingly we bring to your attention the forthcoming satellite broadcast "Dementia and Physical Co-morbidity"

Attention to and appropriate treatment of physical co-morbidities in dementia patients is an important aspect of their advanced care planning and management. For persons already burdened with a high level of disability, other common health conditions such as diabetes, asthma and cardiovascular disease can significantly impact on an already compromised quality of life.

For the health practitioners who support dementia patients, co-morbidity can pose unique challenges which necessitate an approach that acknowledges the person's dementia and their preferences for treatment.

Rural Health Education Foundation Broadcast on Wednesday 6th December 2006 at 8pm AEDT

A Rural Health Education Foundation Satellite Television Broadcast on Wednesday 6th December 2006 at 8pm AEDT, provides information on specific management strategies to treat co-morbidity problems in dementia patients as part of a coordinated approach to ensuring holistic care. Issues around when to stop treatment of co-morbidities and end of life issues are also covered.

In watching this program, participants will:

• Increase their understanding of the challenges and issues in managing dementia patients with common co-morbid health conditions.

• Learn ways to create a dementia-specific management plan for co-morbid conditions in all care settings.

• Identify the antecedents of change in a co-morbid condition and the necessity for advanced planning to avoid acute care admission where possible.

• Understand the role of advanced care directives as enablers of choice for ongoing management of co-morbid conditions.

Panellists include:

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

• Dr Mark Yates
  Geriatrician and Clinical Director, Aged Care Rehabilitation Medicine, Ballarat Health Services VIC.

• Ms Sharon Wall
  Registered Geriatric Nurse Practitioner, Ageing By Caring, Austinmer NSW.

• Ms Julie Letts
  Principal Policy Analyst in Clinical Ethics, Research and Ethics Branch, NSW Health Department, and Board Member, Australian & New Zealand Institute of Health, Law & Ethics Inc.

• Dr Denise Ruth
  Rural General Practitioner, Apollo Bay VIC.

For more details please go to the http://www.rhef.com.au/programs/616b/616b.html program page

Seeking consumer applications - HealthConnect SA

HealthConnect SA is seeking applications from consumers interested in participating in a Consumer Reference Group to provide advice for its care planning project.

This project is planning to implement a care planning and communication system aimed at improving the health outcomes of patients with chronic conditions, by fostering communication and collaboration between members of the patient’s health care team (including GPs, specialists, community health, allied health providers and pharmacies). The system will also encourage patients to play an active role in the management of their condition by providing them with secure access to their care plan via the Internet.

See the Terms of Reference for more details on the project and the role of the Consumer Reference Group.

Applications should be made in writing, addressing the selection criteria outlined in the Terms of Reference, and forwarded to:

Eleanor Royle
Project Manager HealthConnect SA
PO Box 287
Rundle Mall
Adelaide SA 5000

Applications will be accepted until close of business on Friday, 15 December 2006.

Successful applicants will be notified by Friday, 19 January 2007.

The first meeting will be held in February 2007 (date, time and location to be confirmed).

Contact Eleanor Royle on 8226-3008 with any further enquiries.

Terms of Reference (58KB PDF)

Research Funding Opportunities