February 2007

Asthma and allergic rhinitis - make the connection

Exploring links between asthma and allergic rhinitis

Unscheduled trips to doctor for childhood asthma attacks reduced

Patient-centred strategies - impact on long term chronic conditions

NAC positions available

Research Funding Opportunities

Conference Diary 2007

Asthma and allergic rhinitis - make the connection

The National Asthma Council Australia and the Australasian Society of Clinical Immunology and Allergy have released a new consumer information guide, Allergic rhinitis and your asthma: What you should know, specifically aimed at helping people with asthma and allergic rhinitis breathe easier.

Hay fever is the most obvious and easily recognised type of allergic rhinitis and it is particularly prevalent during spring and right through the warmer months.

According to Associate Professor Mimi Tang, chairperson of the expert working group responsible for writing the guide, the prevalence of allergic rhinitis is increasing. Figures from an International Study of Asthma and Allergy in Childhood (ISAAC), show that rates of allergic rhinitis in Australia have continued to rise in the past decade.

There is a strong link between asthma and allergic rhinitis.

Symptoms of allergic rhinitis can be any combination of itching (in the nose, back of throat and eyes), sneezing, runny nose or eyes, and a blocked nose. Many ‘sneeze and bear it’, but according to Assoc Prof Tang, it is important to find out if you have allergic rhinitis and control the symptoms instead of simply trying to cope with them, especially if you have asthma.

Anyone who has asthma and allergic rhinitis – or suspects they might have – should obtain a copy of the new information guide: Allergic rhinitis and your asthma: What you should know, as the information brochure helps explain the link between allergic rhinitis and asthma and gives clear, concise information on how to minimise the daily impact of both conditions.

Brochures are available from your GP or pharmacist or follow the link below.

Resources

Allergic rhinitis and your asthma: What you should know

Allergic rhinitis and the patient with asthma: A guide for health professionals

Exploring links between asthma and allergic rhinitis

The National Asthma Council's Asthma and Allergic Rhinitis will screen live on the Rural Health Education Foundation satellite network on the evening of Tuesday 20 March.

There is a clear interrelationship between asthma and allergic rhinitis. Approximately 10% of all Australians have asthma, and allergic rhinitis occurs in an estimated 75-80% of these asthma patients. Conversely, 20-30% of patients with known allergic rhinitis also have asthma.

Diagnosis of allergic rhinitis may be confusing and symptoms can easily be mistaken for asthma. The impact of allergic rhinitis can significantly affect a person’s daily quality of life and when it occurs in conjunction with asthma, can complicate airway symptoms. Patients with allergic rhinitis severe enough to impair activities or worsen asthma control may need pre-emptive treatment as part of their management plan. Effective management of asthma and allergic rhinitis requires a combined approach.

This program discusses the evidence for the clinical interrelationship and investigation and appropriate treatment of allergic rhinitis in asthma patients.

Program presenters:

Associate Professor Connie Katelaris,
Senior Consultant in Clinical Immunology and Allergy at Westmead Hospital.

Prof. Katelaris also holds the position of Associate Professor (Clinical) at the University of Sydney and Deputy Director (Clinical) of the Institute of Immunology and Allergy Research.

She is a past president of the Australasian Society of Clinical Immunology and Allergy and is currently an Executive member of the Board of the Asthma Foundation of NSW and the World Allergy Organisation.

Associate Professor Frank Thien,
Respiratory and Allergy Physician at the Alfred and Box Hill Hospitals and Monash University in Melbourne.

Prof. Thien is also Adjunct Professor at RMIT University and has clinical, teaching and research interests in asthma and allergy.

He is Secretary-General of the Asia Pacific Association of Allergology and Clinical Immunology (APAACI), Vice President & Secretary of the Chinese Health Foundation of Australia (CHFA), Fellow of the College of Chest Physicians (FCCP), and Member of the American and  Australia/New Zealand Thoracic Societies (ATS, TSANZ) and the Australasian Society of Allergy & Clinical Immunology (ASCIA).

Mr Peter Holder,
Community pharmacist in Canberra.

Mr Holder is the Pharmaceutical Society of Australia representative on the National Asthma Council Board and a member of NAC Pharmacists' Asthma Group.

Associate Professor Ian Charlton,
General Practitioner from Kincumber in New South Wales and Conjoint Associate Professor for the School of Medicine and Public Health at the University of Newcastle.

Dr Charlton is the Founding Chairman of the National Asthma Council's influential General Practitioners' Asthma Group.

Dr Norman Swan (Panel Chair)

Dr Norman Swan (MBChB FRCP DCH) regularly presents Rural Health Education Foundation satellite broadcasts and his award-winning Health Report, which he produces and presents for ABC Radio National, as well as his other ABC Radio and Television program hosting.

Broadcast details

The program will be broadcast live on Channel 4 of the Rural Health Education Foundation's satellite network on Tuesday 20 March 2007 at:

• 8.00pm in ACT, NSW, VIC & TAS.

• 7.30pm in SA.

• 7.00pm in QLD.

• 6.30pm in NT.

• 6.00pm in WA (& repeated in WA at 8.00pm on channel 23).

The program will be repeated on Friday 23 March 2007 see http://www.rhef.com.au/programs/703/703.html for full details.

Program accreditation

This program is accredited for CPD/CPE by the Royal Australian College of General Practitioners, the Australian College of Rural and Remote Medicine, the Pharmaceutical Society of Australia, the Royal College of Nursing Australia and the Australian Physiotherapy Association.

Resources

Rural Health Education Foundation Programs

National Asthma Council Australia programs with Rural Health Education Foundation

Unscheduled trips to doctor for childhood asthma attacks reduced

Young children with attacks of sporadic, recurring asthma who were treated with the prescription drug montelukast by their parents had fewer unscheduled trips to the doctor, missed fewer days from school or childcare, and caused their parents to take fewer days off work for their care.

Results from this multi-center, randomized, double-blind and placebo-controlled trial appeared in the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.¹

Professor Colin F. Robertson, of the Department of Respiratory Medicine at Royal Children's Hospital in Melbourne, and eight associates studied 202 children, ages 2 to 14, who were given either montelukast or placebo by their parents when needed for one year. All of the children had intermittent, doctor-diagnosed asthma.

By the end of the year-long study, the patients treated with montelukast had 163 unscheduled health resource visits for their illness, as compared with 228 in the placebo group.

In asthma, children's airways become chronically inflamed, with various stimuli causing episodes of airway obstruction and breathing difficulties. The disease is the most common chronic disorder of childhood and affects an estimated 6.2 million children under age 18 in the U.S.

Intermittent asthma is the most common pattern of the disease in children, accounting for attacks in 75 percent of affected youngsters.

Montelukast sodium, a specific leukotriene receptor antagonist that has been shown to be effective in children, is used to prevent mild, persistent asthma. It reduces the swelling and inflammation that tend to close airways, and relaxes the walls of the bronchial tubes, allowing more air to pass through to the lungs.

Acute episodes of asthma in young children place a significant burden on healthcare resources. Admission to the hospital for asthma in children aged 0 to 4 years is five times more common, and for those aged 5 to 14 years, twice as common as for adults who have asthma. Professor Colin F. Robertson

The study was designed to evaluate parent-initiated therapy with montelukast at the onset of each upper respiratory infection or asthma symptom. Treatment continued for a minimum of seven days or until symptoms had resolved for 24 hours.

A key component of the study was the impact of asthma on the family, as measured by days absent from school or childcare, nights of disturbed sleep, and the number of parent days lost from work. Furthermore, the strategy of parent-initiated therapy required children on average to take the study drug only 30 days per year, rather than 365, providing a further cost-benefit for the family. Professor Colin F. Robertson

The authors noted that there was no significant reduction in specialist care, hospitalizations, duration of episodes, or use of beta-agonists and prednisolone as a result of montelukast study.

An analysis of cost showed that the use of montelukast resulted in a savings of $124 Australian dollars or 29 percent less per treated episode than the placebo controlled arm of the trial.

Reference

1. Robertson CF, Price D, Henry R, Mellis C, Glasgow N, Fitzgerald D, Lee AJ, Turner J, Sant M. Short-course montelukast for intermittent asthma in children: a randomized controlled trial. Am J Respir Crit Care Med. 2007 Feb 15;175(4):323-9. Epub 2006 Nov 16.

(Abstract: http://ajrccm.atsjournals.org/cgi/content/abstract/175/4/323)

Patient-centred strategies - impact on long term chronic conditions

On Friday 23 March, Mrs Sue Cross, who is the National Project Manager of the General Practice Nursing Project: General Practice Nursing – Getting it Right for Patients and Public Health, in the Working in Partnership Program (WiPP), will be speaking at a Melbourne workshop.

WiPP was established in the United Kingdom under their General Medical Services contract to develop and implement a strategy for general practice to use clinician’s time effectively whilst improving availability of services for patients. Thirteen initiatives have been developed, of which the GP Nursing Project is one. This initiative supports the development of general practice nursing in order to improve recruitment and retention, facilitate a broader skills mix, raise standards and minimise risk.

WiPP seeks to:

• implement new ways of working, including team based care and new skill mixes,

• develop the public’s capacity to self care and manage minor illnesses and develop and deliver effective,

• integrated self-care services, largely provided by the community and voluntary sectors, and

• reduce reliance on mainstream NHS services

Sue is well known internationally and in the UK through her work as Director of Training at the National Asthma and Respiratory Training Centre in Warwick (UK) and as International Project Manager of the Respiratory Education Resource Centre in Liverpool, developing respiratory training for health professionals ‘abroad’. She has been closely involved in the development of the nurse practitioner role in the UK and through the International Council of Nurses. More recently, Sue was Associate Director of Primary Care Nursing for Bedfordshire and Hertfordshire until her appointment to WiPP.

The workshop is for

• movers and shakers interested in self-management, long term chronic conditions and people with disability

• policy officers in government and advocacy groups

• academics

• Doctors, nurses and Allied Healthcare providers

The program will include discussion of

• NHS reforms in Primary Care and an overview of the Working in Partnership Program (WiPP)in the UK

• WiPP GP Nursing project

• Patient centred strategies in the UK

• Relevance for Australia

Workshop Details

Date: Friday 23 March 2007

Time: 9.00 – 11.30 am

Venue: Asthma Foundation of Victoria, 491 King Street, West Melbourne

RSVP: Friday 16 March 2007 to Jane London 03 8699 0565 or jane.london@racgp.org.au

Cost: No Charge

Flyer:   An opportunity … to meet Sue Cross and hear about developments in Primary Care in the UK

Mrs Cross’ trip has been supported by an unrestricted educational grant from Pfizer Australia

Resources

Patient-Centred Health Care

NAC positions available

Project Officer

The National Asthma Council Australia is seeking a skilled and committed part-time Project Officer for an exciting and challenging national asthma education project.

Previous experience delivering asthma activities will be highly regarded.

The Project Officer will be responsible for the implementation of the GP and Allied Health Professional Asthma Education Program.

For further information on this position please contact:
Rhonda Cleveland, National Asthma Council Australia
Phone: 03 8699 0537 or email rhonda@nationalasthma.org.au 

Project Manager

The National Asthma Council Australia is also looking for a Project Manager to work with a small team of dedicated staff, medical writers and consultants.

Excellent skills in stakeholder relations (national and international) with health professionals, directors, committee members and consumers are needed, along with very good editing and writing experience and ability.

A clinical background is desirable, preferably in the respiratory field.

For further information on this position please email nac@nationalasthma.org.au 

Research Funding Opportunities