New guidelines for asthma care and management

In its first major update since 2014, the National Asthma Council Australia’s online Australian Asthma Handbook  continues setting the standard for asthma care and management, and providing crucial guidance to health professionals across the country.

Developed by an interdisciplinary team of clinical experts, Version 2.0 of the national guidelines remains focused on primary care. It provides GPs, pharmacists and nurses with an evidence-based practical resource that support a team approach to improving the lives of the 2.7 million Australians with asthma.

The updated Handbook includes significant expansions to the acute and severe asthma sections as well as an update on paediatric asthma advice. It  is particularly important for healthcare professionals working in remote and rural locations, who commonly manage asthma across a wide spectrum of presentations and  severity.   

There are significant changes in managing acute asthma in diverse clinical settings, including recommendations for initial bronchodilator to include routine use of ipratropium for patients with severe or life-threatening acute asthma, additional recommendations around the use of adrenalin, and revision of oxygen situation thresholds.

The inclusion of risk factors for poor outcomes, in addition to clinical status at assessment after treatment as criteria for hospital admission will be particularly useful for those working in rural and remote locations. Discharge guidance and interim asthma action plans will help coordinate care after discharge, particularly for patients returning home after an admission in a regional centre.

Changes in the paediatric section include updates to medications; for example, there are no longer recommendations for loading doses of steroids in flare ups, as well as new advice that wheezing infants less than 12 months old should not be treated for asthma, as wheezing in this age group is most commonly due to acute viral bronchiolitis or to small and/or floppy airways. Reference is also made to the current bronchiolitis management guidelines.

Major revisions around primary prevention include a summary of the latest evidence on risks and protective factors for developing asthma, and the effects of nutrition, allergen avoidance and restriction diets as well as dietary supplements during pregnancy.

Focusing on a patient-centred approach and including evidence of lived experience of asthma, the management challenges outlined in the new Handbook also give health professionals practical information about the costs of asthma medicines and strategies for how to minimise the costs to their patients.

The addition of advice on providing ongoing care during monoclonal antibody therapy, and add-on treatments, as well as updated and detailed information on identifying severe asthma, provides health professionals with the assurance they need to help patients through some of the most challenging aspects of this chronic condition. 

Released in tandem with the Handbook, the updated My Asthma Guide is also an essential tool for patients in rural and remote areas where accessibility may be limited. Now available in English and translated into Arabic, Persian, Chinese and Vietnamese, the Guide gives patients the practical advice and strategies they need to better understand their asthma and helps individuals, families and children maintain good control at every stage.

Visit www.nationalasthma.org.au to find the a full suite of asthma management and care resources for health professionals and patients.