‘Completely preventable’ asthma deaths skyrocket by 32%

Michelle Wisbey

30/11/2023 3:22:11 PM

The concerning trend saw 467 Australians die last year, but experts say most could have been avoided with the right safeguards in place.

Closeup of senior woman using inhaler.
Women over 75 are most at risk of asthma-related death, accounting for 45% of all fatalities.

Asthma deaths have jumped 32% in just one year, despite doctors pleading with patients to take their diagnosis seriously.
New data from the Australian Bureau of Statistics shows there were 467 asthma-related deaths recorded in Australia in 2022, up from 355 in 2021.
South Australia recorded a particularly stark increase, with deaths rising by 88% in the 12-month period, while Queensland saw a 73% increase.
Dr Kerry Hancock, Chair of RACGP Specific Interests Respiratory Medicine described the results as ‘disappointing but not surprising’.
‘A lot of the mortality is completely preventable and if people can protect themselves from viruses, which we proved people can do through the pandemic, then we need to encourage our patients to maintain good control of their asthma,’ she told newsGP.
‘Through the height of the pandemic, deaths were down … and there were a lot of activities put in place that we always knew would help reduce deaths, such as all the non-pharmaceutical interventions to keep people away from viruses.
‘But as we opened up and became more socially connected again there was a resurgence in viral infections and viruses are a trigger for asthma, especially in people who don’t have well-controlled asthma.’
Asthma deaths returned to their highest point last year since 2016–17, after COVID-induced precautions saw rates dip in 2021.
And it is women over 75 who are most at risk, accounting for 45% of all fatalities.
Overall, 299 females and 168 males lost their lives.
Dr Hancock said one factor leading to these unnecessary deaths is when ‘natural behaviour intervenes’ and patients become non-adherent to their medication.
‘They have a sense of complacency, especially if they feel that the asthma is not too much of an issue for them, then they start to not take the medication or they don’t take it regularly,’ she said.
‘It is a serious disease even when you have mild asthma and people can still die from attacks even when they’re deemed to have mild asthma.
‘We know that there are a whole range of medications, it’s not a one size fits all, that we can target to patients at all levels of asthma … [and] there are also non-pharmaceutical interventions to keep people safe.’
She said these interventions include staying away from people who have a cold, staying away from young children with viral infections, frequent hand washing, and protecting yourself from the environment, including pollens and grasses.
Currently, around one in nine Australians report living with asthma, but National Asthma Council Australia Director Professor Peter Wark said without significant changes to healthcare, death rates will continue to climb.
‘What is of most concern is that most of these deaths are preventable, and many relate to undertreatment, especially in regard to the use of inhaled corticosteroids,’ he said.
‘In addition, there is still limited use of as-needed inhaled corticosteroid/formoterol for people with mild asthma as recommended by the Australian and international guidelines as being just as effective as regular inhaled corticosteroids and much more effective and safer than using relievers alone.
‘This more flexible approach to treatment is ideally suited to people with mild asthma, many of whom are now at risk because they are not using an inhaled corticosteroid preventer.’
Earlier this year, the National Asthma Council released updated versions of two widely used educational charts to help keep healthcare professionals up to date with management pathways.
But with preventable deaths still on the rise, Dr Hancock’s advice for GPs struggling to get the message across to their patients is to talk about the data and hone in on the importance of preventive action.
‘We try not to scaremonger … but even if people think “well, it’s not going to happen to me, I’m not going to die”, it can still interfere with their quality of life, their exercise capacity, enjoyment of life, or sleep,’ she said.
‘It’s a totally treatable disease, and no, it’s not curable, but we do have some amazing medications now to be able to manage those patients with the greatest severity asthma to mild asthma.
‘People need to know that more than 400 people a year in Australia die from asthma and that’s not an insignificant number of people for a disease that is preventable.’
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A.Prof Christopher David Hogan   1/12/2023 7:10:19 PM

According to John Philpot Curran , the price of freedom is eternal vigilance.
Getting our patients to appreciate the potential severity of asthma & the need for eternal vigilance is not a matter of information but education.
Education is a process of integrating new learning into people’s pre-existing knowledge & beliefs. It is not just facts as people interpret information through a lens of what they know or think they know.
Sadly community health literacy is atrocious. I doubt that many people know enough to understand Dr Google or the anecdotes of influencers. Doctors must be educators who use time effectively & ask more questions than give answers their patients have not digested.
We also need to interact with the patient & those who support them- their informal carers

Dr Peter James Strickland   2/12/2023 3:39:22 PM

With all the advances is asthma treatment there has been a massive decrease in asthma morbidity. BUT, some respiratory specialists had IV aminophylline taken off the GPs emergency bag medications years ago, and simply because they did NOT know how to use it to prevent hypotension and nausea, Aminophylline saved many of my patients from asthma distress whilst oral steroids were beginning to work after those patients had taken too much Ventolin -type medications. Asthma is an inflammatory disease, and the primary treatment is STEROIDS as well as initial bronchodilators --no ifs or buts! Aminophylline in an emergency situation is also a useful tool, and can save lives in the acute phase.

Dr Gnanasegaran Xavier   3/12/2023 7:16:29 PM

I feel no patients with asthma should DIE.
Why are you showing a patient using a SALBUTAMOL INHALER!!!!!!!!!
Combination of a corticosteroid inhaler should be should have been shown in the picture.Thanks More use of PEF measurements would help,