News

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‘Good asthma management’ crucial for GPs

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A new Queensland study on asthma hospitalisations for children is a timely reminder for GPs to ensure good asthma management plans are in place for their young patients as winter approaches, says an RACGP expert.
 
Using 20 years of asthma admissions data, the Queensland University of Technology (QUT) study reveals children’s asthma hospitalisations can vary significantly depending on location, season and a child’s age and sex.
 
Examining admissions from 2000–19, the study’s key findings include:
 

• hot desert and arid regions consistently showed the highest asthma risk, sometimes more than nine times the state average 
• boys had higher hospitalisation rates at ages 0–4, 5–9 and 10–14, whereas girls had higher rates during adolescence, aged 15–19
• for children aged 0–4, the peak hospitalisation time was May, with mainly boys
• across all ages, boys showed a stronger February peak while girls showed a broader winter pattern. 

 
Chair of RACGP Specific Interests Respiratory Medicine, Dr Kerry Hancock, told newsGP that although none of the findings are too surprising, it is ‘a great study with amazing data’.
 
‘It is consistent with previous information, such as higher prevalence in young males with the switch in prevalence at puberty leading to higher prevalence in adult females,’ she said.
 
‘Also, the peaks in the winter months due to respiratory viruses in the colder regions, and the return-to-school peak in February being higher in boys.’
 
The report also notes that hospital admissions for the 0–4 age group more than halved during the 20-year period, while admission rates rose among older age groups.
 
Researchers said changes in diagnostic and admission practices over that time ‘might have played a role’, rather than a reduction in asthma burden, which remains high in children.
 
In 2024, asthma was the leading cause of disease burden for children aged 1–9.
 
Dr Hancock agrees the drop in asthma admissions in the 0–4 age cohort ‘could certainly be for the reasons’ stated in the study.
 
‘New guidelines a decade or so ago did change the terminology, so maybe those young children were not coded as asthma admissions,’ she said.
 
‘Also, they are often only admitted to short-stay wards for observation and therefore possibly not included as “admissions” in some of the latter years.’ 
 
The Adelaide-based GP said although the study highlights the importance of campaigns and policies tailored to specific areas, some findings are relevant to other states and territories.
 
‘In Queensland there are different climate and environmental zones influencing asthma rates and risk of flare-ups and hospitalisations, so it is appropriate the public awareness campaigns are tailored to the particular region,’ Dr Hancock said.
 
‘I am sure the [authors’] conclusions would be relevant to similar environmental regions in other states.
 
‘We know the prevalence of asthma hospitalisations in South Australia was higher in the rural and regional areas, which we assume is due to higher allergen and air pollution load, such as rye grass, dust, bushfire and woodfire smoke, and maybe other factors such as social disadvantage, health literacy and access to services.’
 
Dr Hancock said the study serves as a reminder of the importance of ‘good asthma management’, amid what she believes is a ‘decline in interest and participation’ among GPs in asthma management.
 
She addressed this concern in the recently released asthma reform blueprint from the Future of Asthma experts group.
 
‘Some of us believe there has been a complacency about asthma management in primary care,’ she said.
 
‘Many other conditions seem to take a higher priority and interest for GPs than managing chronic respiratory conditions – such as obesity management, ADHD, iron infusions – influenced by patient demand and better remuneration.
 
‘This is compounded by poor remuneration to provide long consultations for comprehensive reviews and diagnostic tests such as spirometry, and sometimes poor or challenging access to spirometry services.’ 
 
It is important patients attend for regular asthma review to ensure medication adherence and correct inhaler use, and action plans are being followed, she says. And given that infection is still the major cause of flare-ups, influenza vaccination also remains key to reducing the risk of respiratory infections and asthma flare-ups in both children and adults.

Dr Hancock said the new quick reference guides released last week by the National Asthma Council will be ‘extremely useful for GPs and their team members’.
 
‘They give a pretty good summary of the critical information in the recently updated Australian Asthma Handbook,’ she said.
 
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