AsthmaUpdate

Inside this issue...Asthma medications: pullout guide

Celebrating 50 years of service

World Asthma Day

Make your medications work for you

A new treatment for asthma?

Issue 43 July 2011

Asthma Australia comprises the Asthma Foundations from each state and territory, working together on national policy, advocacy and programs

and promoting research.

The Foundations have created a new visual brand for our national Asthma Australia identity. The blue

balloon in the logo was chosen because it reminds people about breathing and the importance of

healthy lungs. A balloon needs air to reach its full potential and it links in people’s minds with fun and

freedom.

Adelaide-based company sector7g undertook the initial brand concept work and are a valued partner

in its implementation.

ContentsFrom the President 5Events50th Anniversary 6

World Asthma Day 6

Asthma, Allergy & Anaphylaxis Conference 7

Feature- MedicationsMake your medications work for you 10

Do you experiment with your asthma medication? 12

Asthma medications: a new guide 15-17

Medications and devices 20

New style Epipen 29

Remember to include your asthma medication

in planning for an emergency 30

Living with asthma10 Things to tell/ask your doctor 14

Partners in Lung Health 26

Bello Alita 28

Asthma Action Plans 29

Working with Australian Men’s Shed Association 30

Lung health checklist 31

General InformationHave we found a new treatment for asthma? 8

Asthma Community Education sessions 9

Carers Allowance 11

NPS: Better choices > Better health 28

Asthma Emergency kits 19

Foundations in Focus 22-25WOMAdelaide 22

Fresh air grows solid babies 23

Partnership to assist children in childcare with asthma 24

Bike Hike 25

ContactsAsthma Update

PO Box 603 KENT TOWN SA 5071P: 0404 690 552

E: editor@asthmaaustralia.org.auasthmaaustralia.org.au

Published by Asthma Australia© July 2011 Asthma Australia

Content PanelJan Saunders, Nathalie Maconachie,

Sara Morgan, Cathy Beswick, Paula Murray

Design groupCara Christofi, Tom Chladek,

Jo Weisman

DisclaimerAll Asthma Australia information is endorsed by our Medical and

Scientific Advisory Committee and is consistent with the National

Asthma Council Australia clinical guidelines.

Asthma Australia information does not replace professional

medical advice. People should ask their doctor any questions about

diagnosis and treatment. This magazine can be copied for

education purposes.

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From the President

I am delighted to be writing my first editorial as the new President of Asthma Australia.

2011 marks the 50th anniversary of the Asthma Foundation in New South Wales and the beginning of Asthma Foundations nationally. This is a good time to acknowledge the visionary work of those who established the Foundations, the professionalism and commitment of our staff, and the generous support of our partners, volunteers and supporters, without whom we would not be able to continue our work to help the one in ten Australians with asthma to breathe better.

This issue of Asthma Update focuses on making your medications work for you. It features Professor Carol Armour who was recently awarded the first Asthma Australia award for a presentation at the meeting of the Thoracic Society of Australia and New Zealand, held recently in Perth. The award was for the best presentation about asthma education or improving asthma

The Australian Institute of Health and Welfare has recently released a snapshot of the latest statistics on asthma in Australia. The snapshot provides the following ‘asthma by numbers’:— One in ten Australians has asthma – over 2 million people— $606 million was spent on asthma treatment in 2004-2005— Between 1998-99 and 2009-10 visits to a GP by children

dropped 43%— There were 37 641 hospitalisations for asthma in 2007-2008

(0.5% of all hospitalisations)— In 2007 385 people died from asthmaaihw.gov.au/asthma-and-chronic-respiratory-diseases/

management in the community. The work undertaken by Professor Carol Amour and her colleagues at the University of Sydney has shown that up to 90% of people with asthma do not use their medications properly. This means people will continue to have trouble breathing; are more likely to go to hospital; and in the end it costs them and the community more.

We also feature Assoc Professor Kay Price whose team is looking at the way people experiment with their medications, taking a ‘trial and error’ approach to their health care based on information they gather from places such as the internet, friends and television.

We include extracts from our new medications brochure which sets out to help people understand the difference between their reliever and preventer medication and how to use each one properly.

This issue gives a range of examples of the important leadership role being undertaken by the Foundations and the high quality of this work. Examples are the recent national conference conducted by The Asthma Foundation of Victoria; acknowledgement by the South Australian Governor of the socially inclusive work of staff member Clara Tait; and partnership work with NPS: Better choices Better health, Council on the Ageing and The Australian Lung Foundation.We invite you to complete and return the postcard distributed with this magazine which asks you about future issues - or to complete the survey @asthmaaustralia.org.au

Terry Evans LLMPresidentAsthma Australia

To get a free copy of the Asthma Medications brochure and to find out more about asthma and making your asthma medication work for you:contact your local Asthma Foundation1800 645 130asthmaaustralia.org.au

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50th Anniversary

2011 marks the 50th year since the beginning of Asthma Foundations in Australia. Asthma Foundation NSW was established in 1961, with

Foundations opening in every State and Territory (apart from NT) in the first 5 years.

Who would have thought 50 years ago, when asthma was not yet recognised as a medical condition, that treatments would be available to minimise and eliminate symptoms enabling people to live healthy and active lives. We have come a long way, but there is still more to be done.

A celebration was held at Government House, Sydney

in February, attended by the Foundations’ co-founder Mrs Mickie Halliday-Hardie and AFNSW Patron, Her Excellency The Governor of NSW Professor Marie Bashir. Other guests included many of the past and present volunteers, Board members, committee members, ambassadors and staff members who helped, and continue to help, in building the strong organisation we have today. To view a short film of the Foundation’s history visit youtube.com/asthmansw Asthma Foundation NSW 50th.

Tuesday 3rd May was World Asthma Day and Foundations carried out a variety of activities to promote asthma. The Asthma Foundation WA marked the occasion with a stand in the main thoroughfare at Sir Charles Gairdener Hospital, one of Western Australia’s largest and busiest tertiary hospitals.

Throughout the day, our team of asthma educators assisted more than 30 people who stopped by to talk about their asthma or get more information. Many of these took up the offer of attending a free education session or a free Living Well With Asthma community talk.

World Asthma Day 2011

Mrs Mickie Halliday-Hardie

WAD Sir Charles Gairdener Hospital

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The Asthma Foundation of Victoria hosted the Asthma, Allergy and Anaphylaxis Conference 2011 with the theme of Personalising treatment and care. CEO of The Asthma Foundation of Victoria, Robin Ould said that the Conference theme reflected the commitment of the Asthma Foundations throughout Australia to reduce the impact of asthma, allergy and anaphylaxis and the impact that these illnesses have on the daily lives of many Australians.

The Asthma Foundation of Victoria organising committee developed a comprehensive program providing the opportunity for delegates to hear from a number of International and Australian speakers through a mix of keynote plenary sessions, specific issue presentations and practical skills workshops. In all, 38 separate sessions were conducted covering a diverse range of topics including current statistics, research, treatments, access to care, diagnosis and management and development of asthma action plans and use of devices.

Professor Ian Pavord, a leading English researcher, physician, editor of Thorax Magazine and principal medical advisor to Asthma UK was the keynote speaker. Ian presented on four separate topics including speaking to a combined Thoracic Society and ASCIA meeting of specialists. Over 350 people participated in the conference of which 255 were registrants. Delegates were drawn from asthma educators, nurses,

researchers, general practitioners, pharmacists and allied health professionals. The Conference had representation from all States and Territories in Australia, the United Arab Emirates, Iran, USA, New Zealand and South Africa.

Robin Ould stated, We must acknowledge the support of our exhibitors and sponsors including our platinum sponsor; GlaxoSmithKline and gold sponsors; AstraZeneca and the Federal Department of Health and Ageing. Without the support of industry, a conference such as this would not be possible.

93% of conference delegates indicated an overall satisfaction rating of very good/excellent. This gave a clear statement from delegates that undertaking the wider brief of asthma, allergy and anaphylaxis in a combined way was beneficial.

Asthma, Allergy and Anaphylaxis Conference 2011

Speakers at the conference (top-bottom, left-right) Prof Susan Sawyer, Prof Michael Pain, Prof Robyn O’Hehir, Assoc Prof Jo Douglass, Prof Guy Marks, Prof Anne Chang, Assoc Prof Katie Allen, Prof Gary Anderson, Prof Ian Pavord and Prof Michael Abramson

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Asthma Australia’s South Australian Community Support Coordinator Clara Tait was selected as a finalist in the 2010 Governor of South Australia’s Multicultural Awards. Clara received a special commendation from the Governor in recognition of her work at Asthma Foundation SA in supporting SA Multicultural communities.

Clara’s nomination and commendation is an acknowledgement of her expertise, commitment and passion in delivering respiratory health education and information support to culturally and linguistically diverse communities both on a state and national level.

Thanks to Clara’s involvement across a range of multicultural communities, she coordinated the production of radio community service announcements in 10 languages, promoting better asthma management. The CSA’s are being broadcast across metropolitan and rural radio programs in South Australia.

Led by Dr Jay Horvat from the University of Newcastle, this exciting research funded by Asthma Foundation NSW, explores potential alternatives to steroids in asthma treatment. As many as 1 in 5 people with asthma have a more severe form called neutrophilic asthma, and Dr Horvat’s research has found that neutrophilic asthma is resistant to steroid treatment – the mainstay of asthma therapy.

An even more significant finding was that when mice were induced with neutrophilic asthma and then treated with the antibiotic Clarithromycin, features of asthma were suppressed.

These findings highlight the fact that alternatives to steroids may need to be considered when treating/preventing infection-induced, neutrophilic asthma and that further research is needed into the effectiveness of antibiotic-based therapies in the treatment of disease. Dr Jay Horvat, University of Newcastle.

Asthma Foundation NSW is proud to be able to provide support to innovative researchers such as Dr Horvat, and to be part of such groundbreaking research. The future of asthma understanding and treatment comes from these beginnings.

Governor of South Australia Multicultural Award

Have we found a new treatment for asthma?

Above: Mr Hieu Van Le AO, Lieutenant Governor of South Australia, and Chairman of South Australian Multicultural and Ethnic Affairs Commission and Clara Tait

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Asthma Australia, through its Community Support Program*, offers education sessions to a wide range of community groups. These sessions help people understand asthma, how to recognise it and how to look after someone who is having an asthma attack.

An important part of these sessions is learning about the most common types of asthma medication and how they work. It can often be confusing for people with asthma to work out what their medication does, how to take it and when to take it.

Asthma education sessions cover:— Different types of medication— How they help your asthma — When to use them— Device demonstrations— Puffers and spacers

Many people are unsure how they should be using their devices and

may feel uncomfortable about asking their doctor. These sessions offer an opportunity to learn more and pick up some practical tips on using asthma medication.

Often a simple correction in how asthma medication is taken can make a significant change in the reduction of asthma symptoms, or side effects. For example, many people using puffers are not aware that using a spacer can deliver much more medication into the lungs – instead of just to the back of the mouth.

Understanding your asthma medication is a key step toward living well with asthma. To find out more about asthma medication or attending an education session near you contact your local Asthma Foundation1800 645 130asthmaaustralia.org.au

* The Asthma Community Support Program is funded by the Commonwealth Government as part of its Asthma Management Program. Since the program commenced in November 2009 over 13 000 people have received direct assistance with their asthma management.

10% of the people supported identify as being of Aboriginal or Torres Strait Islander descent; a third of the sessions have been in rural and remote communities; over half of the people supported were in low socioeconomic communities and a third of people supported were from culturally and linguistically diverse backgrounds.

Asthma Community Education Sessions

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located. In this study we set out to determine how best to deliver asthma services from a community pharmacy and to test how well these services work, i.e. do people with asthma obtain better asthma control, and whether any positive effects produced are sustainable.

The service we developed involved 3 or 4 in-depth consultations for people with asthma over a six month period with a specially trained community pharmacist. At each consultation, people with asthma were offered an individualised service based on their needs. The pharmacist reviewed their asthma control, trigger factors, medication use, asthma action plan, inhaler technique and lung function. After this information had been collected, the pharmacist provided a series of interventions which focused around what the patient needed, either in terms of information provision, education and/or referral back to their GP. At the end of each consultation each person with asthma set a goal for

the next visit, and this goal focused on what was important for them.

Specific measures were undertaken to see if the pharmacist service had produced any effects. These measures were asthma control, quality of life, perceived control of asthma, asthma knowledge, asthma medication use (what and how much was used), and use of health services. These were assessed at the beginning and end of the study and 6 months after it had been completed.

We found that:— People who received

the pharmacy service experienced significant improvements in their asthma

— Focusing on medications, as asthma control improved, there was a measurable reduction in the need for reliever medications (blue reliever puffers ie Ventolin)

— If inhalers are not used correctly, they do not deliver the right amount of drug needed in the lungs in an efficient manner

Many studies have now reported that although people with asthma may originally have used their inhaler optimally, with time this optimal technique deteriorates. This means that their asthma control is not the best it could be and that they are probably using too much drug because most of it is not getting into the lung. These findings were confirmed in this study where we found that

Make your medications work for you

It was with great pleasure that I accepted the first Asthma Australia award at the meeting of the Thoracic Society of Australia and New Zealand, held recently in Perth. The Asthma Australia award is for a presentation about asthma education or improving asthma management in the community. I am grateful for the support of Asthma Australia and for the support it gives people with asthma.

Our research work is designed to improve asthma services and the care for people in the community. Community pharmacists are able to assist in care, they have expertise in medications in terms of how and why to use them, and they are readily accessible and conveniently

Professor Carol Armour is a member of the medical faculty at the University of Sydney and located at the Woolcock Institute of Medical Research.

Professor Carol Amour

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This study involved community pharmacists who were specially trained to assess and look after people with asthma. Although not everyone has access to a pharmacist with this specialised training at present, community pharmacists can assist you and your doctor to manage your asthma. We suggest that you talk to your pharmacist or doctor and give them a demonstration of how you use your inhaler each day. Just a small change in your technique can make a big difference to how you feel and whether you need more medicines, and might even mean that your dose can be reduced. So make your medicines work for you and ask for help from your pharmacist the next time you get your inhaler.

Recently a mother, with 3 young children who all have asthma, contacted Asthma Foundation NT to highlight key information regarding the availability of Government support with medication costs for eligible carers.

The children were all diagnosed with asthma at a young age and this mother was spending $90 every four weeks just on preventers for them. A conversation with a Community Development officer at the children’s school led her to hear about Carers Allowance.

After completing the paperwork, including having the children’s doctor complete a section, the family submitted the forms. Their successful application now entitles the three children to health care cards, reducing monthly costs to under $20.

correct inhaler technique was only demonstrated by as few as 20-30 % (depending on which inhaler was being used) of people in the study. With a quick demonstration and some help, this improved to 60-70% at the end

Make your medicines work for you continued from previous page...

This information is not widely known and may be beneficial to many people. Many people struggle with the cost of medications and often will miss filling a script if they do not have the money available to spend.

Carer Allowance can be paid in addition to wages or other income support payments such as Age Pension, Carer Payment (caring for a child under 16 years) or Parenting Payment.

This information can be found on www.centrelink.gov.au or contact your local centrelink office.

Carers Allowance (caring for a child under 16 years) is a supplementary payment that may be available if you are a parent or carer who provides additional care and attention on a daily basis for a child aged under 16 years with a physical, intellectual or psychiatric disability.

of the 6 month service, so many more people were receiving the full dose of drug they needed to keep their asthma under control. Thus in terms of outcomes, asthma control improved and people felt better. More patients were also using a

preventer medication at the end of the service, which was another sign that asthma management had been improved. These positive effects were sustained at 6 months follow up.

Carers Allowance

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Our study has found that people often: — stop taking prescribed

medications before the doctor tells them to

— decide to reduce or increase their doses and change the way they take their medicine before their doctor tells them to

— use the internet to find out about medications and stop or change doing what the doctor has advised because of internet or other information; and

— take over the counter medications (OTC) & complementary and alternative medicines (CAMS) without telling their doctor.

Over the last two and a half years, my colleagues Associate Professor Anne Taylor, Professor Debbie Kralik and I have conducted what we call a mixed methods study about the views of people living with chronic conditions. Our argument is that people living with chronic conditions like asthma and COPD use trial and error practices (i.e. experimentation with themselves as the experimental subject) as a self-care decision-making strategy. This self-care decision making strategy is used to assist them to make sense of what is/is not possible for them to do in everyday circumstances.

Through our research we have learnt more about trial and error practices:— Decisions people make are not

necessarily made while being mindful of the impact on their future health status and health care costs (services, medicines, technologies) and

— This self-care decision-making activity has the potential to cause (an) adverse event(s) if a decision is not based on the best available evidence taking

into account their overall health status.

The results of the study reveal that:— People who experiment with

medicines do not always follow what their doctor advises

— People use trial and error practices to reduce the effects of their illness, such as reducing stress and making adjustments to the pace of their daily life; and

— Trial and error practices are also driven by the relationship between people and the doctor. This prompts our question as to what it may be about the doctor-patient relationship that prompts experimentation with medicines?

Our team is keen to hear your views about how health practitioners can be more effective in assisting the way that people use medicines. Please feel free to share your views with me via my email or telephone.

Dr Kay Price, Associate Professor - School of Nursing and Midwifery (08) 8302-2721kay.price@unisa.edu.au

Do you experiment with your asthma medication?Associate Professor Kay Price talks about her work looking at how people take their medications for asthma, COPD and other on-going health conditions. Her research looks at the decisions people make about what medicines they take and when and how they take them. The national study was funded by the Department of Health and Ageing through the Sharing Health Care Initiative. The project website has the full details: http://www.unisa.edu.au/nur/research/projects/chronic_disease/default.asp

There has always been a recognised need for people, in their everyday lives, to have the information they need to make decisions about medicines; the National Medicines Policy (2000) exemplifies this: http://www.health.gov.au/internet/main/publishing.nsf/content/nmp-objectives-policy.htm. In this policy a medicine includes prescription and non-prescription medicines, including complementary healthcare products. Australia's National Medicines Policy seeks to bring about better health outcomes for all Australians, focusing especially on people's access to, and wise use of, medicines.

Associate ProfesSorKay Price

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Live well with asthma

Live well with asthma

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10 Things to tell/ask your doctor

If you have asthma, chances are that you are keen to stay well and do the things you enjoy – without asthma getting in the way.

One step in achieving this is working with your doctor to ensure you are taking the right asthma medication to help keep you well.

However, everyone has experienced that familiar feeling of seeing your doctor – and remembering what you wanted to ask or tell them about your asthma – after you leave the surgery!

To assist in making your visit to the doctor as worthwhile as possible,

Asthma Australia has produced a simple guide – 10 Things to tell/ask your doctor.

The guide looks at:— Symptoms— Triggers— Medications— Asthma plansand points out important things to tell or ask your doctor.

Some of these things you may know are important, others you may not have thought about in relation to your asthma. By working through these points, you will help the doctor work with you to manage your asthma.

For example it is useful for the doctor to know if you have:— Been waking at night coughing— Been taking your blue reliever

puffer every day for the last few weeks

— Been forgetting to take your preventer at night

— Heard about asthma action plans and would like one to help you manage your asthma.

The information you provide will help your doctor work with you to come up with the best asthma plan to help you live well with asthma.

Contact your local Foundation and ask about 10 things and other resources: 1800 645 130 (office hours)

asthmaaustralia.org.au

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Asthma Australia has produced a new resource to help people understand the difference between their reliever and preventer medication and how to use each one properly. Foundation staff have some key messages for people with asthma and their carers:

— Preventer medication takes time to work. It needs to be taken every day as instructed by your doctor – not just when you don’t feel well

— Reliever medication is for emergency use when you are not well. If you use it more than three times a week check with your doctor, you probably need a review of your asthma action plan

— Always use a spacer to take your puffer medication. Without it you don’t get all the medication you need into your airways

— Get a written asthma action plan from your doctor and follow the medication instructions in it

And for everyone:— Learn how to give asthma first aid using an Asthma Emergency Kit with reliever medication and a

spacer

To get a free copy of the Asthma Medications brochure and to find out more about asthma and making your asthma medication work for you:

contact your local Asthma Foundation:1800 645 130 (office hours)asthmaaustralia.org.au

Translating and Interpreting service: 131 450

Asthma medications – a new guide

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Preventer Medication - Autumn/Desert Colours

Useful InformationCommon Names Alvesco, Flixotide, Pulmicort, Qvar,

Intal Forte, TiladeSingulair Tablet

CorticosteroidNon-steroidNon-steroid tablet

What it does Reduces swellingReduces mucus

Preventers make airways less sensitive

How long it takes to work

Starts to work within one day Singulair – within one day

Preventers can take days and even several weeks to fully work

How to take it Inhaled - Alvesco, Flixotide, Intal Forte, Pulmicort, Qvar, TiladeOral tablet - Singulair

See the devices section to check if you are taking your medication properly

When to take it Every day as prescribed Take your preventer every day as prescribed even if you feel well

Helpful to know The key to keeping well with asthma Preventers are most effective if you take them every day as prescribed

Common side effects Corticosteroid - possible side effects include oral thrush, voice change, sore mouth and throatIntal Forte and Tilade - cough after useSingulair – headaches and stomach upset

You can reduce this byusing a spacer with puffers.Always rinse, gargle and spit after using preventer medication.Clean your teeth after use.Speak to your doctor if you are concerned regarding any side effects

Useful InformationCommon Names Airomir, Asmol, Bricanyl, Ventolin Commonly called blue reliever puffer

What it does Relaxes tight airway muscles Keeps airways open for up to 4-6 hours

How long it takes to work

Very quickly Provides relief from symptoms within 4 minutes

How to take it Inhaled See the devices section to check if you are taking your medication properly

When to take it When you have symptoms Symptoms may include: BreathlessnessWheezingTight chest Persistent cough

Emergency Use a blue reliever puffer with a spacer for Asthma First Aid

Before exercise as prescribed

Exercise can trigger asthma. Speak to your doctor about managing your asthma so you can continue to exercise

Helpful to know Carry it with you always In case of symptoms, or for Asthma First Aid

If you are using your blue reliever puffer 3 or more times per week

See your doctor for an asthma review

Common side effects Shakes, rapid heartbeatChildren can become restless

This will pass quickly. Speak to your doctor if concerned

Reliever Medication - Blue

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Useful InformationCommon Names Alvesco, Flixotide, Pulmicort, Qvar,

Intal Forte, TiladeSingulair Tablet

CorticosteroidNon-steroidNon-steroid tablet

What it does Reduces swellingReduces mucus

Preventers make airways less sensitive

How long it takes to work

Starts to work within one day Singulair – within one day

Preventers can take days and even several weeks to fully work

How to take it Inhaled - Alvesco, Flixotide, Intal Forte, Pulmicort, Qvar, TiladeOral tablet - Singulair

See the devices section to check if you are taking your medication properly

When to take it Every day as prescribed Take your preventer every day as prescribed even if you feel well

Helpful to know The key to keeping well with asthma Preventers are most effective if you take them every day as prescribed

Common side effects Corticosteroid - possible side effects include oral thrush, voice change, sore mouth and throatIntal Forte and Tilade - cough after useSingulair – headaches and stomach upset

You can reduce this byusing a spacer with puffers.Always rinse, gargle and spit after using preventer medication.Clean your teeth after use.Speak to your doctor if you are concerned regarding any side effects

Useful InformationCommon Names Oxis, Serevent Also called long acting relievers

What it does Relaxes tight airway muscles Keeps airways open for up to 12 hours

How long it takes to work

Varies — up to 30 mins Oxis – works within minutesSerevent – up to 30 mins

How to take it Inhaled Always prescribed for use with a corticosteroid preventer See the devices section to check if you are taking your medication properly

When to take it Every day as prescribed Always use with prescribed preventer medication

Helpful to know Prescribed for people who have asthma symptoms even with regular preventer use – always used with a corticosteroid preventer

For example, if a person always takes their preventer, but continues waking at night with asthma symptoms, the doctor may also prescribe a symptom controller, as it can keep airways open for longer than blue reliever medication

Common side effects Shakes, rapid heartbeat, headaches This will pass quickly.Speak to your doctor if you are concerned

Useful InformationCommon Names Seretide (Flixotide and Serevent)

Symbicort (Pulmicort and Oxis)PurpleRed and white

What it does Combination medication =Preventer (reduces swelling + reduces mucus) + symptom controller (relaxes tight airway muscles)

Preventers make airways less sensitive Symptom controllers keep airways open for up to 12 hours

How long it takes to work

Preventer – within one daySymptom controller – varies with type – up to 30 mins

Preventers can take weeks to work fully. Symptom controllers work to keep airways open for longer periods

How to take it Inhaled See the devices section to check if you are taking your medication properly

When to take it Every day as prescribed For Symbicort – SMART*Take your combination medication as prescribed

Helpful to know Prescribed for people who have asthma symptoms even with regular preventer use

Speak to your doctor if you regularly take your preventer and continue to have regular symptoms

Common side effects As for preventer and symptom controllers

Speak to your doctor if you are concerned

Symptom Controller Medication - Green

Combination Medications - Purple or Red & White

Asthma First AidSit the person upright

— Be calm and reassuring — Do not leave them alone

1Give medication

— Shake the blue reliever pu� er* — Use a spacer if you have one — Give 4 separate pu� s into the spacer — Take 4 breaths from the spacer after each pu�

* You can use a Bricanyl Turbuhaler if you do not have accessto a pu� er and spacer

Giving blue reliever medication to someone who doesn’t haveasthma is unlikely to harm them

Wait 4 minutes

— If there is no improvement, repeat step 2

If there is still no improvement call emergency assistance (DIAL 000)

— Tell the operator the person is having an asthma attack — Keep giving 4 pu� s every 4 minutes while you waitfor emergency assistance

4

To � nd out more contact your local Asthma Foundation:

1800 645 130asthmaaustralia.org.au

Translating and Interpreting Service: 131 450© Asthma Australia September 2010 Supported by the Australian Government

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3

Call emergency assistance immediately (DIAL 000)if the person’s asthma suddenly becomes worse

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One in nine Australian children has asthma. In recognition of this and the impact asthma has on many children and their families, the Australian Government funds Asthma Australia to conduct asthma training for school and preschool staff throughout Australia*. These sessions provide staff with the skills and knowledge to recognise the signs and symptoms of asthma, know the correct asthma first aid procedure and to confidently manage an asthma attack. Staff are provided with an overview of asthma, including understanding the condition and how to recognise it. An important component of this training is discussion of exercise induced asthma, as this is a common concern for teachers

School and preschool staff taught to use Asthma Emergency Kits

Asthma Emergency Kits

conducting physical education lessons and for sports days. Staff are provided with an overview of asthma medications, with the emphasis on reliever medication used to provide asthma first aid.This training looks at:— Asthma facts— Asthma management and

medications— Assessing an asthma attack— Asthma First AidInformation for safe asthma management practices for a school or preschool setting are also covered in the session, including quick and safe access for students to their medication; Asthma Emergency Kits available for all on and off-site activities; safe storage of medications; and Asthma Action Plans from the child’s doctor.

To find out more about the school and preschool program:contact your local Asthma Foundation1800 645 130asthmaaustralia.org.au

* The Asthma Child and Adolescent Program is funded by the Commonwealth Government as part of its Asthma Management Program. Since the program commenced in November 2009 over 60,000 school and preschool staff have attended. This program also provides information for parents and supports adolescents to improve self-management of their asthma.

“I’ve learnt more at this one hour asthma training session than I have in 24 years of raising children with asthma.” Teacher who attended the program

Asthma First AidSit the person upright

— Be calm and reassuring — Do not leave them alone

1Give medication

— Shake the blue reliever pu� er* — Use a spacer if you have one — Give 4 separate pu� s into the spacer — Take 4 breaths from the spacer after each pu�

* You can use a Bricanyl Turbuhaler if you do not have accessto a pu� er and spacer

Giving blue reliever medication to someone who doesn’t haveasthma is unlikely to harm them

Wait 4 minutes

— If there is no improvement, repeat step 2

If there is still no improvement call emergency assistance (DIAL 000)

— Tell the operator the person is having an asthma attack — Keep giving 4 pu� s every 4 minutes while you waitfor emergency assistance

4

To � nd out more contact your local Asthma Foundation:

1800 645 130asthmaaustralia.org.au

Translating and Interpreting Service: 131 450© Asthma Australia September 2010 Supported by the Australian Government

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3

Call emergency assistance immediately (DIAL 000)if the person’s asthma suddenly becomes worse

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Asthma medications work very well when taken properly. However, many people with asthma put up with symptoms when they don’t need to affecting their every day life. Making your medicine work for you is an important step in living well with asthma.

Know what you’re takingWhat should I be taking?Everyone with asthma should have a reliever medication. Relievers are fast acting medications that give quick relief of asthma symptoms (wheeze, cough, shortness of breath, tight chest). They open the airways by relaxing the muscle around the airway. Relievers include Airomir, Asmol, Bricanyl and Ventolin.Everyone with asthma should carry a reliever medication with them to use when they have asthma symptoms.

For those people that have more frequent symptoms (i.e. they are needing to use their reliever medication three or more times a week), they might also need to take a preventer medication. Preventer inhalers include Alvesco,

Flixotide, Intal, Pulmicort, Qvar and Tilade. There is also a tablet called Singulair.

Preventer medications make the airways less sensitive, reduce redness and swelling and help to dry up mucus. Preventers need to be taken every day to reduce symptoms and asthma attacks, and it may take a few weeks before they reach their full effect. Your doctor will adjust your preventer medication to the lowest dose you need to keep your asthma well-controlled.If you are still having symptoms, your doctor may increase your dose of preventer, or may give you a combination medication such as Seretide or Symbicort. These inhalers contain a preventer and a symptom controller that helps relax

the tight airway muscles. These must also be taken every day.

Use a spacerEveryone who uses a puffer for their asthma medication is recommended to use a spacer. This will help to get more of the medication into your lungs and can reduce side effects. Spacers

come in many different shapes and sizes – talk with your doctor, pharmacist or Asthma Foundation about which will suit you best. Small children will need to use a face mask with their spacer.

Check your styleAsthma medications are usually breathed in, but they can come in a variety of different devices. It’s important to know how your puffer works, and how to look after it. Did you know that up to 90% of people aren’t using their devices correctly? This means they aren’t getting the right dose of medication, and may be at risk of an asthma attack. Get your device technique checked – see your doctor, pharmacist, or Asthma Foundation.

Talk to your GPIf you aren’t happy with the medication you are taking for any reason, talk to your doctor and they may be able to prescribe an appropriate alternative. It’s important to never stop taking your medication, change the dose or type of medication without medical advice first. Stopping your medication could lead to an asthma attack.Many people are concerned about side effects from asthma medications. All medications can have side effects, especially if they are not taken as prescribed. Some side effects only occur when you

Medications and devicesAdvice from Foundation staff

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first start using the medication, or if you increase your dose. If you are unhappy, or are worried about side effects, you should discuss this with your doctor.

Why?The aim of good medication use in asthma management is for you to take the lowest dose of medication required to keep your asthma under control, with the lowest possible level of side effects. Good control means that you are having minimal symptoms, you are sleeping through the night, and you are able to take part in all your normal daily activities. Even if you are well, you should see your doctor at least twice a year for an asthma review and an update of your written asthma action plan.For more information, contact your local Asthma Foundation: 1800 645 130.

Making the time to take asthma seriouslyOne of our Foundations recently came into contact with a person planning to undertake a 3 month sailing trip around Papua New Guinea. The lady was getting prepared for her voyage, and although she usually had mild asthma, decided to have asthma education and organise her medication supplies. Good preparation, yes.

Unfortunately, she became ill with a rare virus that triggered an asthma attack. Her asthma symptoms were not usual or typical for her, and she did not recognise that she was having an asthma attack. The end result was that she had to be airlifted by a helicopter to Cairns Hospital.

Later on, however, she admitted that she had not taken her asthma seriously, despite the education. This experience has certainly changed her view, and she is keen for her story to be told. She now encourages people to carry their blue reliever puffer with them.

When you find out you have asthma, it doesn’t mean you cannot do the things you care about. Having the correct asthma medication and learning how to use them are an excellent starting point. However, having asthma does mean you need to adapt your routine to use your asthma medicine, for example, a daily preventer. It is also important to be aware of changes in your symptoms. As this person learnt, worsening asthma may not be typical, and it is a good idea to start asthma first aid, before symptoms become severe.

Medications & Devices continued from previous page...

It’s time to take

asthma seriously

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Asthma Foundation SA staffed an information booth at the internationally renowned World of Music Adelaide Festival (WOMADelaide) in March. The event was attended by 85,000 people, and AFSA had the privilege of being positioned directly adjacent to the main stage. The 4 metre-tall AFSA tear-drop flag, containing the new national branding, was visible to all who attended.

Over 400 people talked with staff about their asthma management and 125 Asthma Control Packs were distributed. A short survey was conducted: the results showed that 50% of people said they did not have an Asthma Action Plan, and 25% claimed that they have missed work as a direct result of asthma. Another surprising statistic was that 40% of respondents claim they never use a spacer with their reliever medication.

These results serve as a reminder that Asthma Foundations play an important role in the education of our community about better asthma management.

Foundations in Focus Helping people breathe better

The Foundations in every state and territory provide asthma information, education, and support to people with asthma, and their carers on a daily basis.

WOMADelaide

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In Western Australia, the Asthma Foundation WA coordinates the Newborn’s Asthma & Parental Smoking Project (NAPS). As part of this, we provide community grants to non-profit organisations.

Grants are given to organisations holding events involving pregnant or post natal Indigenous women that promote the message Fresh Air Grows Solid Babies. Free Asthma Foundation WA anti-smoking resources are also be available at the event.

The Rainbow Coast Neighbourhood Centre in Albany, in WA’s south, was awarded a grant to hold a Fresh Air Teddy Bear’s Picnic in their Community Garden. The young participants and their parents and caregivers had fun playing in the sandpit, exploring the garden for beetles and butterflies and singing songs. They shared a healthy afternoon tea and even planted an asthma friendly garden.

The project is funded by the Australian Government Department of Health and Aging.

For more information on the project, training enquires or to obtain free resources, please contact Kara on 9289 3641 or visit the project website www.smokefreebaby.org.au.

Fresh Air Grows Solid Babies!

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Foundations in Focus

Power and Water Corporation and Asthma Foundation NT have joined forces for two years to provide families with asthma and childcare workers with the latest relevant information about asthma. More importantly this information also includes management of asthma in the event of an asthma emergency.

The Asthma Friendly Childcare program provides a safe environment for children with asthma in childcare. Parents/carers can be confident that if their childcare centre has received training in asthma first aid and has implemented the criteria to become Asthma Friendly their child with asthma will be in good hands.

Asthma Foundation NT is developing new resources for use by childcare workers along with information packs that will be made available to parents/carers. A certificate and Asthma Friendly sticker will be issued to all childcare centres that choose to meet the criteria to become Asthma Friendly.

As part of this program an Asthma in the home booklet will also be produced with a particular focus on asthma triggers in the NT. Power and Water plan to distribute this booklet to all their customers in the NT which will make a significant contribution in raising asthma awareness throughout the Territory. This partnership will also provide best practice information on a significant health issue affecting many families in the Northern Territory.

Asthma Foundation NT is very pleased to welcome Power and Water as a committed local partner who is intent on providing a safer environment for children with asthma in childcare.

Partnership to assist children with asthma in childcare

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The HBF Freeway Bike Hike for Asthma is the largest community cycling event in Western Australia. It’s the flagship fundraising event of the Asthma Foundation WA. This year’s event, held in March, was another great success, with nearly 9,000 riders participating and fundraising over $160,000.

There were three distances available; 10km, 30km or 60km, and all rides finished in the northern suburb of Joondalup, where a number of community activities fostered a great carnival atmosphere.

Special thanks go to our team of volunteers who so generously gave up their time to make the event a success, as well as everyone who supported the event by participating.

The vital funds we raised go towards our education programmes and support services, as well as asthma research, in the hope that one day we will find a cure.

Asthma. It’s about time.

Bike Hike

Foundations in Focus: Continued

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COTA (Council on the Ageing)Asthma Australia is very pleased to be working in partnership with COTA. COTA is the national peak organisation for older Australians representing their interests to federal and state governments - see www.cota.org.au COTA is conducting a national Quality Use of Medicines (QUM) Project, funded by NPS (National Prescribing Service) Better choices > – Better health. Trained volunteer peer educators facilitate free one-hour community-based sessions about medication management and resources to discuss with their doctor and pharmacist. The volunteers also attend community events to promote this work. Asthma Australia plans to work with COTA to add a respiratory health agenda to COTA’s work.

Older Australians have a range of asthma-related issues, for example:— They are more likely to have multiple health conditions requiring multidisciplinary services and multiple

medication — Medications used to manage and treat other conditions may either trigger asthma symptoms or interact

with asthma drugs. Examples are beta blockers to treat heart disease and anti-inflammatory drugs to treat arthritis

— Chronic obstructive pulmonary disease (COPD) often coexists with asthma, and can be overlooked— Asthma medications themselves may have increased side effects in older people — Older people may not respond as well to drug treatment as young people and may require more frequent

adjustments to their treatment — Correct use of asthma inhalers, in particular metered dose inhalers, requires good coordination. Proper

technique may be difficult for older people to adopt, due to arthritis or reduced cognitive ability — Older people may have difficulties in accessing health care because of mobility limitations and other

activity restrictions— The cost of medicine is sometimes an issue — Older people with asthma may need to take preventative actions, such as influenza vaccination, to

minimise the exacerbation of their symptoms due to infections

Partners in lung healthWorking in partnership to help people with asthma and linked conditions breathe better

The Commonwealth Government’s Therapeutic Goods Administration (TGA) helps keep the community safe by regulating medicines, medical devices, blood and tissues. The TGA carries out a range of assessments and monitoring activities to ensure therapeutic goods available in Australia are of an acceptable standard, with the aim of ensuring that the Australian community has access, within a reasonable time, to therapeutic advances.

The TGA website (tga.gov.au) includes a register of therapeutic goods in Australia and explains how medicines are regulated in Australia.

Therapeutic Goods Administration

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Research shows that up to 90% of people on asthma medications are using them incorrectly.

Bashiti IA, Armour CL, Bosnic-Anticevich SZ, Reddel HK. Evaluation of a novel educational strategy, including inhaler-based reminder labels, to improve asthma inhaler technique. Patient Educ Couns. 2008; 72: 26-33

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Making it easy to be medicinewise with top questions lists Consultations with doctors take on average about 12 minutes so it’s easy to forget in that time what information to ask for and share.

A survey conducted by NPS found 60% of people had not asked their doctor or pharmacist any questions the last time they received or purchased a medicine, while 48% had not told their doctor or pharmacist about other medicines they were taking.

From NPS: Better choices > Better health

Each year around 140,000 Australians are hospitalised due to medicine mishaps, many of which involve interactions between medicines and unwanted side-effects. These are often avoidable by being medicinewise – realising what is a medicine, knowing the active ingredient in your medicines and asking the right questions before taking a medicine.

Knowing what is a medicine is half the battle, as many people don’t consider herbs, vitamins, creams or things that can be purchased in a supermarket, like aspirin, to be medicines. If you’re seeking a therapeutic affect from it, it’s a medicine, and has the potential to interact with other medicines, NPS clinical adviser, Dr Danielle Stowasser said.

Top 5 medicinewise questions to ask when thinking about starting or changing a medicine: — Why do I need this medicine? — What are my medicine and non-

medicine options? — What are the benefits and risks

of my treatment options? — Is this treatment option suitable

for me? — Where can I find trusted

information?

Top 5 medicinewise questions to ask when you are taking or going to take a medicine: — What is it for? — What is the active ingredient? — How do I take or use this

medicine correctly? — What are the possible side

effects and what can I do about them?

— What should or shouldn’t I do while taking this medicine?

Find out more or download a printable copy of the NPS medicinewise checklists @nps.org.au/medicinewise

A Queensland mum has developed asthma bags for children based on her experiences with her daughter’s asthma. Bello Alito (which translates as beautiful breath) spokesperson, Alita Howlett, hopes that the MyAsthmaBag™ will assist families with their children’s asthma and empower young people to self-manage their asthma. Bello Alita supports Asthma Australia through the sales of their products which incorporate the Asthma Australia first aid poster. For more information go to belloalito.com.au

Bello Alito

NPS: Better choices > Better health aims to help people make better decisions about medicines and medical tests. They are working to make all Australians medicinewise.

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Research shows over and again that three things help good asthma management:— A written asthma action plan,

written with your doctor— Appropriate medication

management advised by your doctor

— Regular check-ups by your doctor.

Written asthma action plans provide a guide for your asthma management: how to recognise worsening symptoms and how to manage these changes. An action plan helps you control your asthma and lets you get on with the things you enjoy.

Often people put up with symptoms without realising their lungs are saying – take notice! Learning to take notice of your asthma symptoms means that you can take action by following your asthma action plan. The asthma action plan will tell you what you need to do to manage your asthma, perhaps increasing your medication for example. The action plan provides information for each individual, to suit their needs.

There are several types of plans available. The National Asthma Council Australia has just released a handy wallet sized Asthma Action Plan. The plan is a good page size and has an easy folding

system – that comes down to the size of a credit card.

The Asthma Action Plan provides space for your doctor to record:— asthma medications you need— required doses and when to

take them— what to do when your asthma

gets worse— peak flow reading (if used)

On the other side of the plan is a useful summary describing symptoms and how these give you clues to your asthma. It describes what to do:— when well with asthma — when not well with asthma— when symptoms get worse— when there are danger signsThis information can help you recognise symptoms that indicate your asthma is becoming worse.

If you would like an Asthma Action Plan go to: www.nationalasthma.org.au or contact your local Asthma Foundation and ask for the National Asthma Council’s new wallet sized Asthma Action Plan.

Asthma Action Plans

New style Epipen

Auto-injecting devices are used to administer adrenaline to assist someone having a severe allergic reaction (life threatening). This is called anaphylaxis.

Alphapharm, the sponsors of EpiPen, will be introducing a new version from July 2011. This includes both versions (adult and junior).

This new device will eventually replace the original style of Epipen. It will provide the same dose of adrenaline.

There are several new features to note:— A blue safety release— Instructions including pictures— Needle protection.The Epipen works in the same way as the current version

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Asthma Australia and The Australian Lung FoundationWorking together with Australian Men’s Shed Association

Asthma Australia has been working with Australian Men’s Shed Association’s (AMSA) through their Community Engagement Officer, Gary Green.

During Men’s Health Week (13th to 19th June) AMSA carried out Health Checks in over 50 Sheds across Australia in this year. As part of this initiative, Men’s Sheds produced a booklet to help men quickly find out how to access health information.

Asthma Australia invited The Australian Lung Foundation to work with them to develop a lung health checklist. The purpose of this checklist is to look overall at the issues people have with getting out of breath, coughing and other breathing problems. Often this might get put down as part of getting older or just be ignored. It is important, particularly for older people, to look at the overall picture of lung health as many people may have asthma as well as COPD or other lung health issues. There are simple tests doctors can do to find out how healthy your lungs are.

We have seen a number of major community emergencies and disasters in recent times. People have been reminded to plan for evacuation and protection of life and treasured goods. People are also encouraged to plan for their health care, in particular access to medications.— If you have preventer medication – you’ll need to keep taking it every day— Keep your reliever medication and spacer handy – you might be exposed to different triggers, such as mould

and stress— Contact a pharmacist if you don’t have your medication – they have emergency rules that mean they can

help you even if you can’t see a doctor first— When you can, make sure you have a written asthma action plan which includes emergency care.As always, seek medical help if you:— Wake up coughing or wheezing — Have needed your reliever more than 3 times in the last week— Have trouble with your normal level of activity because you are breathless

The Asthma Foundations can provide general information about asthma management:1800 645 130 / asthmaaustralia.org.au

Remember to include your medications in planning for an emergency

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Lung HealthTake a breather – and check out your Lung Health...

Coughing?

Have a new or persistent cough – does it wake you at night?Cough up mucus, phlegm or blood?

Breathless?

Struggle to keep up with others your age or doing your normal activity?Get tight in the chest or wheeze?

Not feeling so good?

Frequently have chest infections?Have chest pain, fatigue or sudden weight loss?

And have you:

Ever smoked?Worked in a job that exposed you to dust, gas or fumes?

If you answered yes to any of these questions, ask your doctor about a lung health check.

Live well, breathe well – breathing matters

To find out more about asthma contact your local Asthma Foundation

1800 645 130asthmaaustralia.org.au

To find out more about lung disease call the Australian Lung Foundation

1800 654 301or take an on-line lung health checklist atlungfoundation.com.au

To find out more about asthma information and training contact:

1800 645 130 (office hours)

asthmaaustralia.org.au

Helping people with asthma breathe better