Target Groups - Strategies

Medical Practitioners

Pharmacists

Asthma Educators

People with asthma and their carers

TARGET - MEDICAL PRACTITIONERS

Action required by organisations such as: The Royal Australian College of General Practitioners (RACGP), the Australasian Society of Clinical Immunology and Allergy (ASCIA), The Thoracic Society of Australia and New Zealand (TSANZ), General Practice Divisions, National Asthma Campaign (NAC), pharmaceutical companies, Asthma Foundations, State and Federal health departments, hospitals, Quit Campaigns.

Implementation bodies are suggested only and other organisations will, no doubt, need to be involved as well.

Education and Training

Action	Suggested Implementation	Related Goals and Strategies
1. Provide more training on best practice as currently defined by the Asthma Management Plan to undergraduate medical practitioners and as part of CME.	RACGP to investigate and implement if necessary. TSANZ and ASCIA to provide educational resources to academic bodies.	G3 S3.1
2. Encourage more medical practitioners to use the Six Step Asthma Management Plan.	TSANZ to evaluate effectiveness of the elements of the Six Step Asthma Management Plan. NAC to work with RACGP and General Practice Divisions to promote use of the Six Step Asthma Management Plan. RACGP to prioritise asthma management as a target for practice grants and GP Division grants.	G3 S3.1
3. Promote benefits of adherence to action plans and the need to counsel patients on asthma management in a culturally appropriate manner.	RACGP, NAC and GP Divisions to develop, implement evaluate general practitioner/patient interventions.	G3 S3.1
4. Encourage appropriate medical and educational follow-up to general practitioners after patients leave hospital.	State health departments, hospitals, GP Divisions, Asthma Foundations and asthma educators to develop, implement and evaluate follow-up mechanisms.	G3 S3.1
5. Provide more training on the theoretical and practical aspects of appropriate allergy Management Plans.	RACGP to investigate and implement if necessary. ASCIA and TSANZ to provide educational resources to academic bodies.	G2 S2.3 S2.5 S2.7

Research And Evaluation

Action	Suggested Implementation	Related Goals and Strategies
1. Involve medical practitioners in the evaluation of asthma management practices, the development of quality assurance mechanisms, and participation in any national systems of data collection for asthma-related primary care.	State health departments, RACGP and GP Divisions to work with the NAC on the evaluation of asthma management practices and the development of quality assurance mechanisms. RACGP and GP Divisions to work with the Federal and State health departments to develop data collection systems for asthma-related primary care. NAC to work with RACGP and GP Divisions to develop surveys to be conducted every few years of asthma management practices of medical practitioners.	G1 S1.1 S1.2
2. Monitor medical practitioners' degree of adherence to agreed best practice guidelines.	RACGP to evaluate and establish monitoring systems.	G1 S1.1 S1.2
3. Implement appropriate measures for genetically predisposed persons including referral of pregnant women for further testing if necessary.	ASCIA to work with State health departments to develop targeted education strategies to advise genetically predisposed persons.	G2 S2.1 S2.2
4. Work towards effective implementation of an asthma allergy plan.	ASCIA to work with TSANZ and NAC to develop, implement and evaluate allergy management plans.	G2 S2.3 S2.5

Management Practices

Action	Suggested Implementation	Related Goals and Strategies
1. Provide medical practitioners with examples of successful communication interventions and strategies to improve adherence and self-management skills.	RACGP and GP Divisions to develop, implement and evaluate such interventions.	G1 S1.4 S1.12 G3 S3.1
2. Provide medical practitioners with relevant culturally appropriate written resources to assist in the communication process.	RACGP, GP Divisions, NAC, Asthma Foundations and Migrant Health Workers to develop such material.	G3 S3.1
3. Medical practitioners to implement the Asthma management practices outlined in the Asthma Management Handbook.	NAC to continue to produce, promote and distribute the Asthma Management Handbook. NAC to develop other educational tools to reinforce its use.	G1 S1.1
4. Identify high-risk patients (those at risk of death).	TSANZ and ASCIA to develop aggressive action plans for high-risk patients using the Asthma Management Handbook as a resource.	G1 S1.7
5. Continue to provide information to discourage smoking.	Quit programs to provide medical practitioners with resources.	G2 S2.4
6. Encourage dietary and environmental modification to minimise risk of atopic disease in babies.	ASCIA to develop information for dissemination in early childhood health centres, prenatal clinics, doctors' rooms, pharmacies, community health centres, high schools, etc.	G2 S2.2
7. Ensure effective public editorial about asthma triggers.	ASCIA, TSANZ and NAC to run public education campaigns. ASCIA, TSANZ and NAC to advise and develop resources on the risks of sensitisation to allergens for medical practitioners.	G3 S3.2
8. Ensure effective management of asthma due to respiratory infections.	Medical practitioners to advise patients of the need for increased medication at the outset of infection.	G2 S2.5

TARGET - PHARMACISTS

Action required by organisations such as: the Pharmaceutical Society of Australia (PSA), the Pharmacy Guild of Australia (PGA), the National Asthma Campaign (NAC), pharmaceutical companies, Asthma Foundations, universities, The Thoracic Society of Australia and New Zealand (TSANZ) and the Australasian Society of Clinical Immunology and Allergy (ASCIA).

Implementation bodies are suggested only, and other organisations will, no doubt, need to be involved as well.

Education And Training

Action	Suggested Implementation	Related Goals and Strategies
1. Provide more training about asthma and the pharmacist's role in the Asthma Management Plan to undergraduate pharmacists and as part of CPE.	PSA to investigate and implement if necessary. PSA to evaluate quality impact of advice given to asthma patients in pharmacies.	G3 S3.1
2. Encourage more pharmacists to participate in the Six Step Asthma Management Plan.	TSANZ and PSA to evaluate the effectiveness ofthe elements of the Six Step Asthma Management Plan. NAC to evaluate, with PSA and PGA, the current use of the Pharmacists' Asthma Management Handbook. NAG, PSA and PGA to undertake assessment of the current needs of pharmacists for effective asthma education and the best way to meet these. NAC to work with PSA to promote the use of the Six Step Asthma Management Plan.	G3 S3.1
3. Further educate pharmacists about the need to counsel patients on asthma management.	PSA to continue to promote counselling by pharmacists.	G3 S3.1
Research And Evaluation
Action	Suggested Implementation	Related Goals and Strategies
1. Involve pharmacists in the evaluation of pharmacy asthma management practices and development of quality assurance mechanisms.	PSA to work with the NAC on the evaluation of asthma management practices and the development of quality assurance mechanisms. PSA to work with the Federal and State health departments as a participant in a national system of data collection.	G1 S1.1 S1.2
2. Monitor degree of adherence by pharmacists to agreed best practice guidelines.	PSA to establish monitoring systems.	G1 S1.1 S1.2
3. Assist with the implementation of appropriate measures for genetically predisposed persons including referral of pregnant women for further testing if necessary.	PSA to work with ASCIA to develop and implement the pharmacist's role in identifying such people for referral for further medical advice.	G2 S2.1 S2.2
4. Assist with the effective implementation of an asthma allergy management plan.	PSA to work with ASCIA to develop the pharmacist's role in this.	G2 S2.3 S2.5
Management Practices
Action	Suggested Implementation	Related Goals ane Strategies
1. Provide pharmacists with ongoing information on their role in asthma management.	PSA and NAC to continue to provide information through the Pharmacists' Asthma Management Handbook, workshops, articles in professional journals, etc.	G3 S3.1
2. Provide pharmacists with patient information resources.	PSA and NAC to supply pharmacists with consumer information on all aspects of asthma management.	G3 S3.3
3. Pharmacists to use Asthma Management Plan as outlined in Pharmacists' Asthma Management Handbook.	NAC to evaluate the role of the Pharmacists' Asthma Management Handbook in enabling pharmacists to give appropriate advice and counselling. NAC to continue to work with PSA and PGA to develop optimal educational strategies for pharmacists.	G1 S1.1

ASTHMA EDUCATORS

Action required by organisations such as: the Australian Association of Asthma Foundations (AAAF), Asthma Educator Associations, National Asthma Campaign (NAC), General Practice Divisions, the Pharmaceutical Society of Australia (PSA), and the Asthma Foundations, the Australian Lung Foundation (ALF) and the Australasian Society of Clinical Immunology and Allergy (ASCIA).

Implementation bodies are suggested only, and other organisations will, no doubt, need to be involved as well.

Education And Training

Action	Suggested Implementation	Related Goals and Strategies
1. Asthma educator associations to establish national standards in training practice.	Asthma educator associations to work with AAAF, the NAC and TSANZ to achieve this.	G3
2. Train asthma educators according to the Asthma Management Plan.	NAC to provide asthma educators with the Asthma Management Handbook and other resources.	G3

Research And Evaluation

Action	Suggested Implementation	Related Goals and Strategies
1. Conduct evaluation of existing asthma educational materials and assess future needs.	Asthma educator associations and AAAF to undertake with teaching institutions, TSANZ, RACGP and PSA.	G3 S3.1
2. Conduct evaluation of the manpower requirements of asthma educators in Australia.	Asthma educator associations and AAAF to undertake with teaching institutions, TSANZ, RACGP and PSA.
3. Conduct evaluation of asthma education interventions at current points of contact (eg: A & E departments) and institute evaluation and implementation of change where appropriate.	Asthma educator associations and AAAF to liaise with hospital administrative bodies to lobby for improved asthma education facilities and resources.	G1 S1.10 G3
Management Practices
Action	Suggested Implementation	Related Goals and Strategies
1. Provide asthma educators with up-to-date information on asthma management such as the Asthma Management Handbook.	NAC to provide Asthma Management Handbook and any other relevant publications.	G3 S3.1
2. Asthma educators to obtain patient information on asthma management.	Asthma Foundations, TSANZ, ALF and NAC to provide patient information.	G3 S3.1
3. Assist asthma educators to develop affordable local asthma education programs.	Asthma educators to work with Asthma Foundations, GP Divisions and pharmacists to develop such programs.	G3 S3.1
4. Ensure that appropriate medical and educational follow-up procedures are put into place for patients leaving hospital after treatment of asthma.	State health departments, hospitals, GP Divisions, Asthma Foundations and asthma educators to develop, implement and evaluate follow-up mechanisms.	G1 S1.9 G3 S3.1

TARGETS - PEOPLE WITH ASTHMA AND THEIR CARERS

Action required by organisations such as: Asthma Foundations, the National Asthma Campaign (NAC), the Royal Australian College of General Practitioners (RACGP), the Pharmaceutical Society of Australia (PSA), General Practice Divisions, Federal and State health departments, Asthma Educator Associations, the Australasian Society of Clinical Immunology and Allergy (ASCIA), hospitals.

Implementation bodies are suggested only, and other organisations will, no doubt, need to be involved as well.

Education And Training

Action	Suggested Implementation	Related Goals and Strategies
1. National awareness and education campaigns on asthma management issues to be conducted regularly, making full use of all media, including the ethnic media.	NAC to continue to implement such campaigns.	G3 S3.2
2. Encourage people with asthma and carers to use the Six Step Asthma Management Plan.	Asthma Foundations, medical practitioners, TSANZ, pharmacists and the NAC to continue to promote use of the Six Step Asthma Management Plan.	G3 S3.1
3. Encourage people with asthma to understand that good asthma management will usually lead to an improved quality of life.	NAC, Asthma Foundations, TSANZ, medical practitioners and pharmacists to continue to promote this concept.	G1 S1.12
4. Encourage people with asthma to seek advice from a doctor, pharmacist, asthma educator or Asthma Foundation.	All public campaigns to refer people with asthma to one or more of these sources.	G3 S3.1
5. Encourage high-risk families to seek advice.	ASCIA to work with TSANZ and NAC to achieve effective access of high-risk families to appropriate advice.	G2 S2.2
6. Encourage people with asthma to discuss an effective asthma allergy management plan with their doctor.	As a consequence of the public education campaigns, people with asthma should be stimulated to ask for this plan.	G2 S2.3
Research And Evaluation
Action	Suggested Implementation	Related Goals and Strategies
1. Investigate the extent to which people with asthma are discriminated against in employment.	AAAF to provide employers with accurate information on asthma and asthma management and attempt to remove any unnecessary discrimination.	G3
2. Investigate equitable access to medications and devices.	NAC to co-ordinate a submission to present to the Federal Minister for Health and Family Services on these cost implications and the need for subsidies.	G3 S3.3
3. Undertake research to discover barriers to the use of preventive medication and promote successful patient interventions.	NAC to continue to encourage research and the development of successful patient interventions.	G1 S1.12
4. Establish guidelines for reduction of discriminatory employment practices.	TSANZ and NAC to work with legal profession to identify and clarify issues relating to discrimination against employees (current and potential) with asthma, and to lobby governments for change in relevant policies.	G3
Management Practices
Action	Suggested Implementation	Related Goals and Strategies
1. Information on all aspects of asthma management to be freely available in a range of community languages.	Asthma Foundations and NAC to develop and distribute such information.	G1 S1.4 G3 S3.1
2. Improve asthma management practices in settings such as schools and in the workplace, sports clinics etc.	Asthma Foundations and NAC to adapt or develop appropriate protocols and encourage their implementation in the various settings.	G3
3. Encourage people with asthma to seek advice from a doctor, pharmacist, asthma educator or Asthma Foundation.	All public campaigns to refer people with asthma to these sources.	G3 S3.1