Chronic respiratory conditions

This report investigates the utility of the Pharmaceuticals Benefits Scheme (PBS) and Medicare Benefits Schedule (MBS) claims data in answering key research questions for reporting on the treatment and management of chronic respiratory conditions in Australia. It also includes high level analysis on medications dispensed for the treatment and management of chronic respiratory conditions in 2016–17, and dispensing patterns.

This working paper outlines the content of a workshop on Developing a national surveillance approach for respiratory epidemics, which was held in Canberra on 3 May 2017. The expert advice received at the workshop from a large array of stakeholders involved in health protection is outlined by providing full summaries of every presentation on the day, along with issues for further consideration which were discussed on the day. This working paper is intended as a resource for policy makers, hospital administrators, clinicians, researchers and peak organisations.

Bronchiectasis is the abnormal widening of the airways in the lungs usually caused by damage to the airway walls. This condition is characterised by a persistent cough with excess amounts of mucus and, often, airflow obstruction together with episodes of worsening symptoms.

This report presents information on the disease burden of chronic respiratory conditions using data from the Australian Burden of Disease Study 2011. Respiratory conditions were the sixth leading contributor to total burden of disease in Australia, with chronic obstructive pulmonary disease (COPD), asthma and upper respiratory conditions being the greatest contributors to the respiratory burden. The burden due to respiratory conditions generally decreased over time, varied by condition severity and by population group, and some of the burden was attributed to modifiable risk factors such as tobacco use.

Allergic rhinitis can occur seasonally (commonly referred to as 'hay fever') or throughout the year. Allergic rhinitis is triggered by an allergic reaction. The symptoms may include a runny or blocked nose and/or sneezing and watery eyes. Common triggers include house dust, animal fur, pollens, fungal spores, air pollutants and occupational triggers such as latex, breads and cereals or small animals.

This demonstration data linkage study investigates the use of lung function testing in the diagnosis and management of chronic airways disease. It uses data from the 45 and Up Study linked to Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) data. The study shows that: - contrary to recommended guidelines, most study participants (82%) initiated on medications for managing their chronic airways disease did not have lung function testing performed within 12 months, either before or after their initial prescription - among respondents who reported having current asthma, lung function testing was only claimed for about one-quarter (26%) in a recent 3-year period and 12% had only 1 lung function test claim during that time. The evidence from this study will inform initiatives to help improve appropriate prescribing and health outcomes for people with chronic airways disease. This project also provides a demonstration of methods that could also potentially be used to fill evidence gaps associated with other chronic diseases such as diabetes, arthritis and cancer.

People with asthma often have other chronic diseases and long-term conditions. These are referred to as 'comorbidities'—two or more health problems that are present at the same time. Comorbidities are typically more common in older age groups.

People with COPD often have other chronic diseases and long-term conditions. These are referred to as 'comorbidities'—two or more health problems that are present at the same time. Comorbidities are typically more common in older age groups.

This report describes patterns of dispensing of respiratory medications in Australia through detailed analyses of Pharmaceutical Benefits Scheme (PBS) data, as well as other sources, to draw inferences about respiratory medication use among patients with asthma and COPD. It provides a valuable update and new information about the use of medicines for asthma and COPD, thus improving our knowledge and understanding about how these diseases are managed in Australia.

Asthma death rates in Australia are high compared with many other countries and chronic obstructive pulmonary disease (COPD) is a leading cause of deaths in Australia and internationally. This report provides current information about mortality due to these conditions in Australia, examining trends over time, seasonal variation, international comparison and variation by age, sex, remoteness, Indigenous status, country of birth and socioeconomic disadvantage.

The pattern of coronary heart disease and chronic obstructive pulmonary disease in Indigenous Australians differs to that in non-Indigenous Australians. This paper shows that Indigenous Australians have higher hospitalisation and death rates for these conditions than non-Indigenous Australians, and are more likely to die from these conditions at younger ages. However there are some encouraging trends seen in the Indigenous population, such as declining death rates from coronary heart disease, improved chronic disease management and declining smoking rates.

Chronic obstructive pulmonary disease (COPD) is a major cause of death and disability in Australia. While pulmonary rehabilitation and long term oxygen therapy are recommended treatments for COPD, there is currently no national information about the supply and use of these therapies. This report outlines a proposed approach to monitoring access to, and utilisation of, these therapies, by capitalising on existing data sources and identifying data development opportunities.

Asthma in pregnant women may have adverse effects on maternal, fetal and infant outcomes, particularly if expectant mothers experience an exacerbation of asthma while pregnant. Pregnancy, in turn, may have adverse effects on asthma control among expectant mothers. This report outlines a proposed approach to monitoring asthma during pregnancy by capitalising on existing data sources as well as identifying data development opportunities.

This report provides an overview of hospitalisation patterns over time and across population groups. Asthma hospitalisation rates decreased between 1998-99 and 2010-11, by 33% for children and 45% for adults. The rate of hospitalisation for asthma among Indigenous Australians was 2.1 times the rate for Other Australians. Asthma hospitalisation rates were also higher for people living in areas with lower socioeconomic status.

This report investigates how hospitalisation rates for asthma and chronic obstructive pulmonary disease (COPD) vary across Australia. Maps in the report show higher hospitalisation rates for both asthma and COPD in inland and rural areas of Australia. Socioeconomic status, remoteness and the proportion of the population that identifies as Indigenous all have a significant association with the hospitalisation rates for asthma and COPD by area.

Research has shown that vaccinations against influenza and pneumococcal infection can benefit people with obstructive airways disease, which includes asthma and chronic obstructive pulmonary disease (COPD). This report reviews the limited information available in Australia on how many people with asthma and COPD have the vaccination, and finds that the uptake rate is not as high as would be expected if recommendations were being followed. It presents a range of data improvement options that would enhance our ability to monitor vaccination uptake in this and other at-risk population groups.

Appropriate use of medications is important in maximising health benefits for patients, minimising the negative effects of medications, and controlling health costs. This report focuses on the appropriate use of certain medications for the management of obstructive airways disease, including asthma and chronic obstructive pulmonary disease (COPD). Data in this report suggest that antibiotics are commonly used among patients with asthma and COPD, and that supply patterns for inhaled corticosteroids are often not consistent with treatment guidelines for the management of these conditions.

Allergic rhinitis can occur seasonally (commonly referred to as 'hay fever') or throughout the year. Allergic rhinitis is triggered by an allergic reaction. The symptoms may include a runny or blocked nose and/or sneezing and watery eyes. Common triggers include house dust, animal fur, pollens, fungal spores, air pollutants and occupational triggers such as latex, breads and cereals or small animals.

Asthma is an important health problem in Australia. This report brings together data from a wide range of sources to describe the current status of asthma in Australia. It includes information on the number of people who have asthma and who visit their general practitioner, are hospitalised or die due to asthma. Time trends and profiles of people who receive various treatments for asthma are also presented, along with information on those who have written asthma action plans. In addition, comorbidities and quality of life among people with asthma are also investigated. This report also includes a chapter that focuses on chronic obstructive pulmonary diseases in Australians aged 55 years and over.

Re-admissions for asthma can be considered an indicator of health system performance in relation to the management of patients with asthma. This bulletin examines the overall rate of re-admissions for asthmas in Australian and investigates time trends in re-admissions for asthmas as well as differences according to age, sex, socioeconomic status and remoteness of residence.