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The following excerpt is from the ANMF’s Asthma Management tutorial on the Continuing Professional Education (CPE) website.

Asthma is a common chronic condition that affects the airways. People with asthma experience episodes of wheezing, shortness of breath, coughing, chest tightness and fatigue due to widespread narrowing of the airways.1

Asthma affects about 11% of the Australian population. That equates to approximately 2.7 million or one in nine Australians.2

Asthma attacks can come on gradually or quickly. When asthma occurs as an acute attack, the airflow restriction can be life-threatening. Each year approximately 400 people in Australia die from asthma.3 Therefore, skilled patient education is vital for effective asthma management.

Asthma is a common inflammatory disease of the airways. It is debilitating and potentially life-threatening, rising in incidence and has no cure.

Normally the airways are open and relaxed, allowing air to easily move in and out. People with asthma have sensitive airways that are primed to react to triggers in the environment, leading to an asthma attack. These triggers vary between different people.

Triggers include:

Pollen, dust mites, mould spores, the common cold, thunderstorms, aspirin, obesity, sinusitis, viral exposure in children, work-related asthma, gastroesophageal reflux disease (GERD), exercise, food, pet dander, bushfire smoke and environmental irritants such as cigarette smoke and pollution.

Asthma is a condition in which the airways narrow and swell and may produce extra mucus. This can make breathing difficult and trigger coughing, wheezing when the person exhales and shortness of breath.

For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack. Asthma can’t be cured, but its symptoms can be controlled.4

In clinical practice, asthma is defined by the presence of both of the following:

  1. Excessive variation in lung function; and
  2. Respiratory symptoms that vary over time and may be present or absent at any point in time.5

The pathophysiology of asthma is complex and involves the following components:

  • Airway inflammation;
  • Intermittent airflow obstruction; and
  • Bronchial hyper-responsiveness.6

The underlying cause of asthma is not completely understood, however evidence suggests that the risk of developing the disease may be significantly increased by:

  • A positive family history (indicating genetic predisposition to the disease);
  • Presence of allergies, such as atopic dermatitis or hay fever;
  • Environmental factors such as exposure to allergens/cigarette smoke;
  • Lifestyle – active and passive smoking;
  • Obesity; and
  • Genetic factors (eg. genetic predisposition to allergies).

Morbidity and mortality may be significantly decreased with:

Appropriate diagnosis, patient education, use of appropriate drug therapy, identification of triggers and reducing contact with them, self-monitoring of signs and symptoms, regular medical review and having a written asthma action plan.

Unfortunately, only one in four people aged 15 years and over have a written asthma action plan. The good news is that 67% of children (under 15) do have an asthma action plan.7

References

  1. National Asthma Council Australia (NACA) 2020, Australian Asthma Handbook, Version 2.1, www.asthmahandbook.org.au/ accessed September 2020.
  2. Australian Bureau of Statistics (ABS) 2018. National Health survey: first results, 2017-18 ABS Cat no. 4364.0.55.001. Canberra, www.abs.gov.au/statistics/health/health-conditions-and-risks/national-health-survey-first-results/latest-release Accessed September 2020.
  3. National Asthma Council Australia (NACA). Asthma Mortality Statistics. www.nationalasthma.org.au/living-with-asthma/resources/health-professionals/reports-and-statistics/asthma-mortality-statistics Accessed September 2020.
  4. Mayo Clinic 2020. Asthma. www.mayoclinic.org/diseases-conditions/asthma/symptoms-causes/syc-20369653 Accessed November 2020.
  5. National Asthma Council Australia (NACA). Definitions and commonly used terms. www.asthmahandbook.org.au/resources/definitions Accessed October 2020.
  6. Morris, MJ and Pearson, DJ 2020. Medscape-Asthma https://medicine.medscape.com/article/296301-overview#a4 Accessed October 2020
  7. Australian Institute of Health and Welfare (AIHW) 2020. Asthma https://www.aihw.gov.au/reports/chronic-respiratory-conditions/asthma/contents/asthma Accessed September 2020.

The following information is a snap shot from ANMF’s Asthma Management tutorial available on the Continuing Professional Education (CPE) website.

The complete tutorial will give you three hours of CPD and covers the following topics: Asthma facts, pathophysiology, etiology, epidemiology, signs, symptoms and triggers, clinical presentation, diagnosis, prognosis, patient education, asthma and allergy, asthma medications, medication administration, spirometry, peak flow meters, asthma action plan, complications of asthma, respiratory assessment, acute asthma attack, first aid for asthma.

To access the complete tutorial go to http://anmf.cliniciansmatrix.com

QNMU, NSWNMA and NT members have access to all learning on the CPE website free as part of their member benefits

For further information, contact the education team at education@anmf.org.au

anmf.org.au/cpe