Introduction 

This sixth edition of the Australian treatment guidelines for asthma, the Asthma Management Handbook, gives us a chance to reflect where we have been since The Thoracic Society of Australia and New Zealand first published the Asthma Management Plan in 1989 in the Medical Journal of Australia. These were the first national treatment guidelines for asthma published anywhere. The Thoracic Society of Australia and New Zealand asked the newly formed National Asthma Council Australia, the National Asthma Campaign as it then was, to take the guidelines to their main target audience, primary care physicians and other relevant health professional groups. That began an ongoing commitment to the distribution and revision of high-quality, user-friendly principles of asthma care and a thorough implementation process.A survey of medical knowledge acquisition published in the Medical Journal of Australia in 1997 found that the asthma treatment guidelines were the second most read reference document after the Antibiotic Guidelines.

Each edition of the Asthma Management Handbook has been developed out of extensive consultation especially with the main user group, primary care physicians, but also with respiratory physicians and scientists, allergists, asthma educators, emergency physicians, pharmacists, industry, government and many expert individuals. New developments in asthma care must be evaluated and presented to clinicians in a lucid and unbiased manner. The structure of the sixth edition does not reflect the Six Step Asthma Management Plan but the principles of this are encapsulated in the Ongoing Care chapter. Information is provided on new drug therapies and their changing role, especially combination therapy with an inhaled corticosteroid and a long-acting beta agonist. We have adopted the GINA classifications of asthma severity used by many other countries, and stressed the importance of recognising patterns of asthma. Emphasis is placed on practical interventions that work, including smoking cessation, weight reduction and matching inhaler device with patient capability. Also, attention is drawn to the diagnosis and treatment of comorbidities including COPD, depression and sleep apnoea, as well as the management of allergic conditions, particularly rhinitis. For years now, the Handbook has also been available on the National Asthma Council’s much-visited website and its pages are some of the most accessed. From this, the sixth edition, the Handbook will be revised annually on the website.

Over sixty people from around Australia have worked on the Handbook, reviewing evidence, assigning levels of evidence and writing chapters. This is the biggest team effort ever for the NAC on the Handbook, and one cannot speak highly enough of so many dedicated health professionals committed to producing the best possible management guidelines. Much of the evidence assessed has been produced in response to clinical need, by researchers in Australia committed to excellence in clinical care. There is a strong sense of national ownership of the Asthma Management Handbook, which is a major contributing factor to the success of its implementation. Government, industry and professional societies have also played an important role in contributing to and reviewing the content.

The National Asthma Council Australia was formed as a coalition many years ago, an excellent and effective model for a national body, and it is this principle of stakeholders working together that has proven to be so effective. A prime example is this Asthma Management Handbook. The task of production is indeed enormous and great credit must go to the commitment of the skilled editorial staff of the NAC. We are all proud of this tremendous effort and dedicate the Asthma Management Handbook 2006 to you all, with many thanks to the Department of Health and Ageing, sponsoring companies and stakeholders.

Professor John Wilson
Chairman
National Asthma Council Australia

Content Created (Thursday, 16 November 2006)