November 2008

Improving inhaler technique

A is for Asthma: Managing Asthma in Primary School Kids

Practical strategies for asthma and allergy at GPCE Melbourne

2009 American Thoracic Society International Conference

Autumn Babies: Born to wheeze?

Research Funding Opportunities

Conference Diary

Improving inhaler technique

Many people with asthma or COPD who rely on preventer and reliever medications delivered via an inhaler to manage their conditions are not using their inhalers properly.

Experts estimate that up to 90 per cent of patients are misusing their inhalers resulting in poor medication delivery, which in turn can lead to reduced quality of life, more frequent and longer hospital stays and even an increased dependence on their medication.

While using inhalers correctly is important for all age groups it is such a concern amongst veterans and other older people that the Department of Veterans’ Affairs has collaborated with Australia’s leading respiratory health organisations The Australian Lung Foundation and the National Asthma Council Australia, as well as the Pharmaceutical Society of Australia, the Pharmacy Guild of Australia and the Australian General Practice Network to create a new community education campaign to get people puffing properly.

The aptly titled: “Prevent Puffer Problems” campaign was launched on November 20 by the Minister for Veterans’ Affairs, the Hon Alan Griffin at Melbourne’s Austin Hospital.
 

The “Prevent Puffer Problems” campaign features a range of easy to understand resources designed to improve inhaler use including self-care cards, which will be available in pharmacies, as well as new inhaler technique video demonstrations and an information paper for health professionals Inhaler technique in adults with asthma and COPD, available on the National Asthma Council Australia’s website.

Six main types of asthma and COPD inhalers currently on the market in Australia are highlighted in the short video clips which shows NAC asthma educator, Judi Wicking, providing patients with step-by-step usage instructions. The videos also include captions to ensure viewers who may be hard of hearing or without sound from their computers, get the right message.

According to Judi Wicking, anyone who uses an inhaler would benefit from reviewing how they use it to ensure they are really getting maximum impact from their medication.

“The fact is most people who use an inhaler aren’t doing it properly. They may never have been shown the correct technique in the first place or they may not have regular usage reviews with their GP or pharmacist, which means poor technique becomes a bad habit,” she said.

Veterans and other older people are particularly prone to problems with inhaler use due to lack of dexterity and sometimes a limited understanding of the manufacturer’s instructions.

“For these people being able to watch another person demonstrating the right way to use the same inhaler that they have been prescribed will be invaluable and the video can be viewed on demand as often as required,” Judi said. She advises anyone who uses an inhaler to ask their GP or pharmacist to physically show them how to use it and recommends regularly asking a health professional to double check technique to ensure no bad habits have crept in.

Common problems include not shaking a puffer between each dose; not holding a Turbuhaler or Accuhaler at the right angle when loading a dose; and, putting multiple doses into a spacer, rather than inhaling each individual dose one at a time.

The campaign also includes an educational component for pharmacists and GPs to help them brush up on their inhaler technique and equip them with up to date information to ensure their patients are puffing properly.

Resources

Using your inhaler

  Standard MDI (puffer)

  Standard MDI (puffer) and spacer

  Accuhaler

  Autohaler

  HandiHaler

Inhaler technique in adults with asthma and COPD

A is for Asthma: Managing Asthma in Primary School Kids

Satellite broadcast Tuesday 27 January 2009

Program summary

‘Back-to-school asthma’ is a common problem in Australia, with a spike in asthma-related hospital visits for school-aged children occurring regularly in the first few weeks after each school holiday period. The highest annual peak is in February as students return from the long summer break.

Although the possibility of a life-threatening episode remains, asthma is a very manageable disease in most children. Good asthma control means a child can live a normal active life, free from emergency department visits or days off school due to asthma.

Asthma in children differs from asthma in adults in clinically important aspects, which include the patterns of symptoms, anatomical factors and recommended treatments. Just in time for the new school year, this program will discuss the latest in best-practice asthma management for primary-school-aged children.

Learning Objectives

 After viewing the program, participants will be able to:

• Diagnose and assess school-aged children with asthma more effectively.
• Understand the indications and treatment regimens of current paediatric asthma medications.
• Develop a systems approach to review periods and medication adjustment for optimum asthma control.
• Update their knowledge of recommended self-management strategies for children with asthma and their carers.

Speakers

Chaired by Dr Norman Swan, Presenter of the Health Report on ABC Radio National, the multidisciplinary panel will comprise:

• Paediatric respiratory physician
• General practitioner
• Community pharmacist
• Paediatric asthma and respiratory educator
• Asthma Friendly Schools coordinator

Broadcast date

 The 60 minute broadcast will take place on Tuesday 27 January 2009

Resources

NAC Asthma Programs with the Rural Health Education Foundation

Practical strategies for asthma and allergy at GPCE Melbourne

'Asthma and Allergy: practical strategies for related conditions' was one of the most popular sessions at General Practitioners’ Conference and Exhibition (GPCE) Melbourne on 16 November. The 1-hour seminar was hosted by the NAC with support from Schering Plough.

Associate Professor Jo Douglass, head of asthma, allergy and immunology at The Alfred, presented a dynamic session covering differential diagnosis and practical strategies for management of concurrent asthma and allergy, using a series of intriguing case studies to illustrate the key points.

There is a strong association between asthma and allergy. Allergic individuals are over three times more likely to develop asthma while 60-80% of asthma patients have coexisting allergic rhinitis or sinusitis.

Resources

Allergic rhinitis and your asthma: What you should know

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

Asthma information brochures for patients

Asthma information papers for Health Professionals

2009 American Thoracic Society International Conference

May 15-20, 2009 San Diego, California

The 2009 American Thoracic Society Conference (ATS 2009) offers new perspectives on the clinical, basic science and translational discoveries that will shape the future of adult and paediatric respiratory care.

San Diego, USA is the location for ATS 2009 and the conference offers over 400 sessions providing a comprehensive review of the latest information on the diagnosis and treatment of respiratory, critical care and sleep disorders.

More than 5,500 original research abstracts will be presented covering asthma, COPD, lung cancer, obstructive sleep apnea, pulmonary hypertension, cystic fibrosis, ARDS, and sarcoidosis.

The Advance Program with registration form will be available in January 2009 from www.thoracic.org.

For more information, please contact the ATS International Conference Department at (212) 315-8652 or ats2009@thoracic.org.

Autumn Babies: Born to wheeze?

It is said that timing is everything, and that certainly appears to be true for autumn infants. Children who are born four months before the height of cold and flu season have a greater risk of developing childhood asthma than children born at any other time of year, according to new research.

The study published in the December of the American Journal of Respiratory and Critical Care Medicine, analysed the birth and medical records of more than 95,000 children and their mothers in Tennessee, USA to determine whether date of birth in relationship to the peak in winter respiratory viruses posed a higher risk for developing early childhood asthma. They found that while having clinically significant bronchiolitis at any age during infancy was associated with an increased risk of childhood asthma, for autumn babies, that risk was the greatest.

"Infant age at the winter virus peak following birth independently predicts asthma development, with the highest risk being for infants born approximately four months prior to the peak, which is represented by birth in the fall months in the Northern hemisphere. Birth during this time conferred a nearly 30 percent increase in odds of developing asthma," said Tina V. Hartert, MD, MPH, associate professor of medicine and director of the centre for Asthma Research at Vanderbilt University, and principal investigator of the study.

The study demonstrated for the first time that timing of birth in relationship to the peak in winter virus activity independently predicts asthma development.

The researchers propose two non-mutually exclusive possible reasons for the link: One, that there is a genetic susceptibility common to both bronchiolitis and the development of asthma; and two, that an environmental exposure such as winter viral infection causes asthma.

"The risk of progressing from bronchiolitis to asthma is almost certainly influenced by genetic factors," wrote Dr Hartert. "However, if this association were due only to genetic factors, there would be a seasonal effect on infection but not on asthma. Instead we have shown that there is variation in the risk of developing asthma by the timing of birth in relationship to the winter virus peak for each year studied. This supports a causal relationship of childhood asthma with the winter virus peak after birth."

Unfortunately, predicting the peak of winter virus season is difficult - it can vary by up to ten weeks a year, and Dr Hartert notes that avoiding winter virus infection would be nearly impossible - 70 percent of infants are infected in their first year of life - but that for families whose infants are at high risk for developing asthma, there are a number of ways to reduce the risks associated with birth timing, including avoiding infection through administration of a vaccine or immunoprophylaxis or timing of birth in the spring months. These strategies hold the hope for asthma prevention, however, these interventions first need to be studied.

Currently no effective primary and secondary asthma prevention measures exits, noted Dr Hastert. "The next critical step is support for studies designed to determine whether prevention of the ubiquitous infections during infancy prevents childhood asthma."

Reference

Wu P, Dupont WD, Griffin MR, Carroll KN, Mitchel EF, Gebretsadik T, Hartert TV. Evidence of a Causal Role of Winter Virus Infection during Infancy in Early Childhood Asthma. Am J Respir Crit Care Med Vol 178. pp 1123–1129, 2008

Research Funding Opportunitiess

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
	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