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The National Asthma Council has released a preview of an updated approach to initiating and adjusting asthma medication in adults and adolescents aged 12 and over that will be added to its Australian Asthma Handbook that provides national guidelines for management of the condition.

The changes recommend the use of a low dose inhaled corticosteroid and rapid onset reliever on an as needed basis as suitable starting treatments for patients with mild asthma, a new approach supported by evidence.

Other advice in the stepped approach remains unchanged.

Published by the National Asthma Council, the Australian Asthma Handbook provides best-practice, evidence-based national guidelines for asthma management for primary health care professionals including nurses.

Another update, which will focus on the issue of underuse of preventer medicines by people with asthma and the corresponding over-reliance on reliever medications, will be published in coming weeks.

“Very few adults and adolescents with asthma can maintain good asthma control relying solely on a short-acting reliever and nearly all adults with asthma will have better health outcomes and quality of life through use of a preventer that contains an inhaled corticosteroid, which addresses the underlying lung inflammation,” said Professor Amanda Barnard, Chair of the Guidelines Committee.

The update coincides with a new PBS listing budesonide/formoterol.

“We welcome the new listing of low dose Symbicort (budesonide/formoterol) as a subsidised medicine under the Pharmaceutical Benefits Scheme for as needed only use by adults and adolescents with mild asthma for its potential to facilitate the use of preventer medication by people who may otherwise over-rely on their reliever.

“However, it’s important to note that short-acting relievers such as salbutamol remain an essential rescue medicine for their role in management of acute asthma and community first-aid. They still provide safe relief of symptoms when used with a regular inhaled corticosteroid preventer,” Professor Barnard added.

The significant update on asthma management was conducted by a multidisciplinary team of experts including primary care clinicians and respiratory specialists, with the development including a comprehensive review of evidence from recent clinical trials and consideration of the Australian health system context and how recommendations would be implemented in primary care.

“As part of the review process, we are consulting with and seeking endorsement from stakeholder groups such as the RACGP, APNA, PSA, and TSANZ on the update. We are also seeking feedback on the implementation of the update from people with asthma,” National Asthma Council CEO Siobhan Brophy said.

The full Handbook update will include detailed guidance for implementation, practice tips and other updates.

Plans for health professional education are also underway to help in the implementation of the new guidelines.

Healthcare professionals are encouraged to access the preview changes on the National Asthma Council Australia website.