Changes to kids’ asthma management highlighted in Handbook update

The National Asthma Council Australia today released a major update of its online Australian Asthma Handbook, the national guidelines for diagnosis and management of asthma in primary care.  

Guidelines Committee Chair and general practitioner Professor Amanda Barnard says Handbook version 2.0, which was developed by an interdisciplinary team of clinical experts, continues to set the standard for asthma management for the 2.7 million Australians with the condition.

‘This update’s focus on paediatric asthma advice reflects the different diagnosis and management approaches required across childhood,’ says Professor Barnard, ‘with the expanded severe asthma and management challenges sections providing guidance on the latest advanced treatment options alongside practical strategies for exploring uncontrolled asthma from an individual patient perspective.’

Also included in the revision is the latest evidence on primary prevention of asthma and updated guidance on managing acute asthma in clinical settings.

‘The Handbook is an evidence-based practical resource for GPs, pharmacists and nurses that supports a team approach to improve asthma outcomes in partnership with patients and their families.’

‘While limited updates have been published in recent years, this edition is the first major review of the Handbook since it went online in 2014 and marks the 8^th edition of asthma guidelines produced by the National Asthma Council Australia,’ says Professor Barnard.

Providing its endorsement to the Handbook Royal Australian College of General Practitioners President Dr Harry Nespolon said the guidelines would play a vital role in the management of asthma in Australian general practice.

‘As the first port of call for Australians with asthma, GPs must have the most up-to-date, evidence-based guidance on asthma management.

'The guidelines will help ensure GPs are able to continue to form the basis of developing personalised asthma plans relevant to their patients with asthma and those with a family history of asthma so they can live healthy lives,' says Dr Nespolon.

The Australian Asthma Handbook continues to be endorsed by health professional peak bodies working in asthma, including the Royal Australian College of General Practitioners, Australian Primary Health Care Nurses Association and the Pharmaceutical Society of Australia.

Access the Australian Asthma Handbook 2.0 and a list of amendments at: www.asthmahandbook.org.au or visit the National Asthma Council Australia website for asthma information: www.nationalasthma.org.au

The National Asthma Council Australia maintained strict editorial independence in developing the Australian Asthma Handbook. Version 2.0 was partially supported by unrestricted educational grants from Boehringer Ingelheim Australia and Novartis Australia.

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Australian Asthma Handbook highlights

• The first major review of the Australian Asthma Handbook incorporates the latest best-practice evidence for GPs, pharmacists and nurses on asthma diagnosis and management.
• The update focuses on paediatric asthma advice which reflects the different diagnosis and management approaches required across childhood.
• Expanded severe asthma and management challenges sections provide guidance on the latest advanced treatment options alongside practical strategies for exploring uncontrolled asthma from an individual patient perspective.

Guidance on managing asthma in children:

• Restructure to separate recommendations for children 1–5 years and 6 years and over to reflect different approach to, and certainty of, asthma diagnosis in these age groups
• No recommendations for specific asthma management in children under 12 months due to emphasise on low probability of asthma and section on wheeze in infancy updated for consistency with national guidelines for management of bronchiolitis
• Reorganisation and update of advice for stepped approach to adjusting medication in children
• Integration of tables for classification of symptom patterns and indications for preventer treatment as a single table for each age group
• Addition of risk factors for life-threatening asthma flare-ups
• Addition of advice on asthma management at the beginning of the school year

Evidence and advice for management of acute asthma:

• Recommendations for initial bronchodilator to include routine use of ipratropium for patients with severe or life-threatening acute asthma
• Revision of oxygen saturation thresholds and targets to reflect Thoracic Society of Australia and New Zealand guidelines
• Revision of discharge guidance to promote effective transition to primary care and addition of templates for interim asthma action plans

Other evidence updates and amendments

Restructure of several sections to improve clarity and site navigation, including new pages for adolescents, severe asthma, and management challenges (formerly troubleshooting)

• A focus on patient-centred care in addressing management challenges
• Addition of statements on over-use of short-acting beta2 agonists to update evidence and emphasise risk
• Updated evidence in primary prevention of asthma
• Updated guidance on prevention of thunderstorm asthma, with targeting of advice for at-risk people to avoid being outdoors before and during springtime thunderstorms only on high-pollen days.