Controlling asthma

By Dr Angela Williams

New Zealand-designed asthma self-management plans are receiving international recognition. Doctors and asthma organisations in Australia, Europe and the United States have adopted plans which the Asthma and Respiratory Foundation of New Zealand first introduced in 1991. The plans were designed to put control in the hands of people with asthma.

A recent medical review, combining 22 studies, has proven the value of good old Kiwi ingenuity. The review shows that self-management education cuts asthma hospitalisations, unscheduled visits to the doctor, days off work or school, and night-time symptoms, by almost half.

In other words asthma self-management improves quality of life and reduces costs.

This year the foundation has modernised the instructions. The changes are based on experience and research gathered over the past eight years.

More than $100 million is spent on asthma medication each year and about $23 million on asthma hospitalisations.

The government agency which controls medicine subsidies, Pharmac, and the Health Funding Authority recognised the value of nipping asthma in the bud by funding this year's update of the plans. Pharmac medical director Dr Tim Smart says:

"The self-management plans are an excellent opportunity to be proactive. They enable people to catch their asthma earlier and to take action before it becomes more severe. We're delighted to have been involved with the foundation in this project."

A lot of planning has gone into the launch of the new plans. A consultative group of general practitioners, health educators and respiratory specialists have put together a user-friendly package for health professionals working with asthma, to ensure a nationwide uptake of the new plans.

The package includes messages for asthma sufferers and health professionals about good management of adult asthma.

The credit card-sized plans come in a handy instruction folder which lets people with asthma know exactly how well they are and what they should do.

Anyone who has struggled to breathe knows what a frightening experience this can be and how important it is to know what to do.

It is easy to underestimate how bad an attack of asthma will be. The first step of the plans helps people decide how well they are, based on their asthma symptoms and/or peak flow rates (a measure of breathing which is easily done in the home). Actions range from a temporary increase in medication to dialling 111 in an emergency.

Self-management plans are designed to be flexible. Doctors can adapt the plans to suit the individual's asthma. This makes them suitable for mild, moderate or severe asthma.

Respiratory physician, Associate Professor Ian Town, who has been involved in the development of the new plans, says a self-management plan should be available to everyone with asthma.

This means half a million New Zealanders stand to benefit. New Zealand has one of the highest rates of asthma in the world. At least 15 per cent of adults are affected and about 32 per cent of 14-year-olds - and the prevalence is increasing. While the new plan is suitable only for adults and teens, a self-management plan for children is also available from doctors, practice nurses and asthma societies.

* Dr Angela Williams is the communications and advocacy manager of the Asthma and Respiratory Foundation. She has worked as a doctor and freelance health writer and has studied public health.