October 2008

Peak Pollen Season is Now!

Bringing vital asthma data together

Closing the best-practice gap

Living with Asthma & Allergy – latest free NAC mini-mag out now

Abstracts from CHEST 2008

Research Funding Opportunities

Conference Diary

Peak pollen season is now!

Hay fever sufferers and people with asthma; beware – peak pollen season is now until late November, according to the latest asthma alert issued by the National Asthma Council Australia.

“There is so much hype at the start of spring about pollen-triggered asthma and allergy that many people don’t realise that the real danger period is actually late spring and sometimes even early summer,” warned Professor John Wilson, National Asthma Council Australia chairman.

“These are the four to six weeks of the year when plant-based and pollen-related asthma is at its peak,” Prof Wilson explained. “Then as summer progresses, pollen distribution tends to fall off and prevailing winds make pollen less of an issue.”

For people with asthma, major thunderstorms at this time of the year can also compound the problem, triggering sudden and severe asthma attacks and an increase in hospital admissions.

“The combination of plenty of pollen in the atmosphere and heavily laden rain clouds, characteristic of thunderstorms, is hazardous,” Prof Wilson said.

“When precipitation occurs, the pollen grains become wet and expand and then burst into smaller particles which can be breathed deep into the lungs, triggering asthma.

“Consequently, thunderstorms increase the allergen load caused by plant species such as rye grass, Bermuda grass and birch and a range of others, exacerbating asthma symptoms.”

To minimise the impact of seasonal asthma and allergy, the National Asthma Council Australia encourages people with known allergies to continue to take their preventative medications to reduce hay fever, rhinitis and asthma, as well as their symptom reliever.

“People with asthma must have an up-to-date written asthma action plan, detailing what to do when symptoms worsen and it is important to avoid exposure to triggers,” Prof Wilson stressed.

“For many, at this time of the year, it’s better indoors than out.”

Further information on asthma triggers and asthma management advice is available from the National Asthma Council Australia’s website resources.

Resources

Written Asthma Action Plans

Asthma and Allergy

Asthma and Allergy - A guide for health professionals

Allergic rhinitis and your asthma: What you should know

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

Bringing vital asthma data together

The 2008 edition of Asthma in Australia brings together data from a wide range of sources to describe the current status of asthma in Australia.

Asthma remains a significant health problem in Australia, with prevalence and death rates that are high by international standards despite declines, according to the third report in the series released recently by the Australian Institute of Health and Welfare (AIHW).

The report estimates that asthma affects more than 1 in 10 Australians - equivalent to over 2 million people.

Professor Guy Marks, Director of the Australian Centre for Asthma Monitoring, said the prevalence of asthma in Australian children is plateauing, if not declining.

'In the long run, this should reduce the overall burden of asthma in Australia,' Professor Marks said.

Report co-author, Leanne Poulos said, 'Although asthma deaths declined significantly between 1989 and 2006, the Australian death rate is still high on an international scale.'

While lower than New Zealand and the UK, asthma death rates in Australia are almost three times the rate in Europe.

Asthma accounted for 402 deaths in Australia in 2006, (the latest figures available).

The report showed that hospital admission rates for asthma have also declined since 1993-94, by 45% among adults and by 42% among children.

'Despite these positive trends, asthma continues to be a major concern in Australia and there are several areas we can work on to improve asthma outcomes,' Professor Marks said.

Of particular concern is that:

• Australians with asthma continue to smoke almost as commonly as people without asthma, despite the known adverse effects.
• An estimated 11% of Australian children with asthma live in homes where smoking occurs inside the home.
• The majority of people with asthma do not have a written asthma action plan, even though national guidelines have recommended their use for the past 20 years.
• Asthma is a major problem among Indigenous Australians. Compared with non-Indigenous Australians, they have higher rates of hospitalisation and mortality due to asthma.

National Asthma Council Australia Chair, Professor John Wilson, welcomed the third edition of Asthma in Australia, which contains vital epidemiological information.

'Of particular interest in this issue is the data on our indigenous communities,' Prof Wilson said.

'We congratulate the ACAM team on their latest valuable publication. Australia is the only country to produce this kind of report and, as such, is much envied.'   

Resource

Asthma in Australia 2008 is available free online at http://www.aihw.gov.au/publications/index.cfm/title/10584

Closing the best-practice gap

Gaps remain in the provision of evidence-based care for patients with asthma in general practice, according to a recently published Australian study by Dr Christopher Barton and colleagues.

Most GPs in this study were not managing asthma in line with recommendations from the National Asthma Council Australia’s Asthma Management Handbook. Only 12% of GPs had performed spirometry in the past year for more than 80% of their patients with moderate to severe asthma and only 13% of GPs had provided written asthma action plans for this patient group.

Although the study data was collected more than 2 years ago – before the latest edition of the Handbook was published – these statistics suggest asthma management in general practice has room for improvement.

GPs and allied health professionals wanting to keep up to date can do so with the NAC’s Asthma Management Handbook 2006, which is still the current edition of the evidence-based guidelines. The Handbook is freely available via the NAC website.

The NAC has been working hard to disseminate evidence-based guidelines for many years. The NAC’s A-Team® asthma education program has been successfully promoting best-practice asthma management for GPs and allied health professionals since 2002.

Demand for the NAC’s newer Spirometry Training Course has been high among GPs and practice nurses keen to up-skill, with the 50 one-day workshops held so far in 2008 well received by participants across Australia.

To access the latest edition of the guidelines or find out about health professional education programs, see Resources below.

Reference

Barton C, Proudfoot J, Amoroso C, Ramsay E, Holton C, Bubner T, Harris M, Beilby J. Management of asthma in Australian general practice: care is still not in line with clinical practice guidelines.
Prim Care Respir J. 2008 Oct 2. pii: pcrj-2008-03-0030. doi: 10.3132/pcrj.2008.00059. [Epub ahead of print]

http://www.thepcrj.org/journ/aop/pcrj-2008-03-0030.pdf

Resources

Asthma Management Handbook 2006

A-Team® Asthma Education Program

Spirometry Training Course

Spirometry resources

Living with Asthma & Allergy – latest free NAC mini-mag out now

Just in time for the peak spring and summer asthma and allergy season comes the new edition of the National Asthma Council Australia's mini-magazine, Living with asthma & allergy - available now as a free add-on bonus with the November 2008 issue of the Australian Women's Weekly.

The new seasonally-themed mini-mag contains information to help people with asthma and allergy survive the sneezing season; minimise exposure to pollens and other triggers such as house dust mites, mould and pets; and manage allergic reactions to the many biting and stinging insects that emerge during the warmer months.

It also features the popular ‘First Aid For Asthma' chart, on the inside front cover, providing ready access to clear advice if an asthma emergency arises.

Published as part of the National Asthma Council Australia's Sensitive Choice program, the mini-mag highlights the growing range of Sensitive Choice registered products, which have been reviewed and accepted by the National Asthma Council Australia's product advisory panel.

Only approved products can use the National Asthma Council Australia's Sensitive Choice branding and feature the program's prominent blue butterfly logo.

Sensitive Choice products featured in the new edition of Living with asthma & allergy range from cleaning and home improvement products to bedding, skin care products and even an alternative to harsh pool and spa chemicals.

Living with asthma & allergy is available free with your November 2008 copy of the Australian Women's Weekly or it can be downloaded from the Sensitive Choice website: www.sensitivechoice.com.au 

Abstracts from CHEST 2008

Selected abstracts from CHEST 2008, the annual scientific meeting of American College of Chest Physicians which is currently in progress at the Pennsylvania Convention Centre, Philadelphia.

Patients’ Home Photos Help Identify Asthma Triggers

The use of in-home photography may be a more cost-effective alternative to in-home inspections for identifying asthma and allergy triggers. Researchers from Truman Medical Center and the University of Missouri, Kansas City, MO, selected 50 adult subjects with persistent asthma to take photos of a predetermined list of areas in their home using a disposable camera. All subjects completed a questionnaire addressing triggers prior to and after taking in-home photos. All film was reviewed with the subjects at the third visit. Subjects then received education on the identified triggers and cost-effective measures to reduce or eliminate exposure. Three of the 50 subjects were randomly selected to receive an in-home assessment by a trained environmental specialist. Triggers identified by in-home inspection by an environmental specialist were very similar to those identified by the use of a disposable camera. Results suggest in-home photography ($13 cost) may be a cost-effective alternative to professional visual home assessments ($300 to $400 cost).

Asthma in Children Changes With the Seasons

Health-care utilization for children with asthma changes with the seasons, peaking in the fall. Using data from the United Healthcare database, researchers from the University of North Carolina reviewed health-care utilization patterns and asthma medication usage in children aged 2 to 5 years and 6 to 12 years from 2002 to 2004. Results showed that health-care utilization was minimal in the summer; however, September consistently served as a point of inflection for health-care utilization for both age groups. In October and November, peak emergency department visits for the two age groups were approximately 2.4 to 2.8 times higher than in July; outpatient visits were approximately 3.1 to 3.3 times higher; and hospitalizations were approximately 3.7 to 5.6 times higher. Asthma controller and reliever medications claims increased beginning in September and peaked in December. Rates for health-care use and claims for asthma medications also were elevated in February.

Swimming Effective Therapy for Asthma

Swimming may be an effective intervention for children with asthma. Taiwanese researchers followed 30 children with asthma to investigate the effects of a 6-week swimming intervention on pulmonary function testing (PFT), peak expiratory flow monitoring (PEFM), and the severity of asthma (SOA). Twenty boys and 10 girls were randomly assigned to receive regular asthma treatment combined with a 6-week swimming training (experimental group) or regular asthma treatment alone (control group). Compared with the control group, the experimental group showed significant improvements in PEFM and SOA. These results suggest that swimming may be an effective nonpharmacologic intervention for children with asthma.

Increased BMI May Blunt Asthma Medications

People who are overweight or obese may not experience the intended effects of asthma medications. In a retrospective analysis, researchers from GlaxoSmithKline analyzed the effect of increasing body mass index (BMI) on achieving asthma control with fluticasone propionate/salmeterol via Diskus compared with montelukast. Overall, a BMI >25 appeared to blunt a person’s response to asthma therapy in general; however the superiority of FSC compared to MON persisted over the entire range of BMIs.

Nasal Spray Improves Rhinitis-Related Chronic Cough

Patients with rhinitis-related chronic cough may be able to control their cough using nasal sprays. Researchers at Cough Center, Inc, in California treated 266 patients (ages 7 to 85 years) with seasonal allergic (3 percent), nonallergic (65 percent), or mixed rhinitis (32 percent) with open-label combinations of azelastine nasal spray, steroid nasal sprays, ipratropium nasal spray, or cromolyn nasal spray. The median duration of cough was 7 years and the percentage of smokers was less than 1 percent. Of the patients, 72 percent with rhinitis-associated chronic cough experienced improvement with intranasal therapy. The most effective combination therapies were azelastine nasal spray with ipratropium and cromolyn sprays (73 percent) and azelastine nasal spray and intranasal steroid sprays (76 percent). Researches conclude that chronic cough, due to both allergic and nonallergic causes of postnasal drip, can be adequately controlled with the use of nasal rinses and sprays.

Abstracts from CHEST 2008

All abstracts from CHEST 2008 may be viewed at http://meeting.chestjournal.org/content/vol134/issue4/index.shtml

Research Funding Opportunities

The National Asthma Council Australia would be pleased to list funding opportunities that may be available for asthma research. Submit brief details for consideration by email to nac@nationalasthma.org.au.

 

 

Conference Diary

Submit brief conference/meeting details to the National Asthma Council Australia for possible posting in our Conference Diary by email to nac@nationalasthma.org.au.

 

2008
	American College of Allergy, Asthma & Immunology 7-12 November 2008 Seattle, United States http://www.acaai.org/
	ASCIA 19th Annual Scientific Meeting 12 - 14 November 2008 Park Hyatt Hotel, Melbourne, Australia http://www.ascia2008.com/
	13th APSR Congress 19-22 November 2008 Bangkok, Thailand http://www.apsr2008.org
	Annual Meeting of Taiwan Society of Pulmonary and Critical Care Medicine 6-7 December 2008 Taipei, Taiwan spccm@mars.seed.net.tw http://www.tspccm.org.tw/
2009
	65th Annual Meeting of American Academy of Allergy, Asthma & Immunology 13-17 March 2009 Washington D.C, United States http://www.aaaai.org/
	TSANZ Annual Scientific Meeting 3-8 April 2009 Darwin, Australia tsanz@fcconventions.com.au
	Annual meeting of the American Lung Association & ATS 15-20 May 2009 San Diego, USA http://www.thoracic.org/
	49th Annual Meeting of the JRS 12-14 June 2009 Tokyo, Japan http://www.jrs.or.jp/
	ERS Annual Congress 12-16 September 2009 Vienna, Austria http://www.ersnet.org/
	Annual International Scientific Assembly of the American College of Chest Physicians 31 October - 5 November 2009 San Diego, United States http://www.chestnet.org/CHEST/
	American College of Allergy, Asthma & Immunology 6-11 November 2009 Miami Beach, United States http://www.acaai.org/
	14th Congress of the APSR 14-18 November 2009 Seoul www.apsresp.org/congress/2009.php