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Asthma is a chronic inflammatory disorder of the airways. People with asthma experience episodes of wheezing, breathlessness and chest tightness due to widespread narrowing of the airways.
1 in 5 people aged 15 and over with asthma have a written asthma action plan, based on 2014–15 self-reported survey data
1 in 9 Australians reported having asthma in 2014–15
About 421 deaths were due to asthma in 2015
General practitioners (GPs) play a central role in the management of asthma in the community.
This role includes assessment, diagnosis, prescription of regular medications, education, provision of written action plans, and regular review as well as managing asthma flare-ups. Asthma-related visits to GPs may occur for a variety of reasons, including:
A survey in 2012 of 2,686 Australians aged 16 and older with current asthma identified that 29% had needed urgent health care for asthma in the previous year . Of these, 23% had urgent need to see their GP, 10% their emergency department or hospital, with 4% needing one or more nights in hospital because of their asthma.
According to the Bettering the Evaluation and Care of Health (BEACH) survey, asthma was one of the most frequently managed chronic problems in the decade up to 2015–16 .
In the ten year period 2006–07 to 2015–16, the estimated rate of asthma management in general practice declined from 2.3 in 100 encounters to 2.0 in 100 encounters (Figure 1). The BEACH survey gathers information from a random sample of GPs in Australia. An 'encounter' is a consultation between a patient and a GP.
There is currently no nationally consistent primary health care data collection to monitor provision of care by GPs. Note that statistics on general practice activities based on BEACH data are derived from a sample survey of GPs and their encounters with patients, and need to be interpreted with some caution.
Source:  (Data table).
Many people with asthma do not have a current written asthma action plan although it is recommended in national guidelines.
A written asthma action plan, prepared for patients with asthma by a health care professional, can help people with asthma to manage their condition and reduce the severity of acute asthma flare-ups.
Asthma action plans have formed part of the National Asthma Council Australia's guidelines for the management of asthma for 28 years  and have been promoted in public education campaigns (including by the National Asthma Council Australia) on the basis that individualised written action plans reduce the risk of dying of asthma and improve asthma health outcomes .
In 2014─15 only 21% of people aged 15 and over, and 57% of children aged 0–14 , with asthma had an asthma action plan (Figure 2), despite recommendations that every person with asthma have an asthma action plan (for more information see the recommendations here: Australian Asthma Handbook - action plans).
Across all ages, in 2014–15, an estimated 699,000 people, that is 28% of people with asthma  reported having a written asthma action plan, an increase from 24% in 2011─12 , 21% in 2007─08  and 16% in 2004─05 .
Among people with asthma, adults aged 25─34 were the least likely to have a written action plan (16%) . This percentage is similar to that recorded in 2011─12 for this age group . Children aged 0─14 were the most likely to have a written asthma plan (57%) , an increase from 41% in 2011─12 , 48% in 2007─08  and 26% in 2004─05 .
Source: National Health Survey: Health Service Usage and Health Related Actions, 2014–15. ABS cat. no. 4364.055.002. Canberra: ABS (Data table).
Use of medicines is the mainstay of asthma management.
In 2014─15 based on self-reported survey data, 35% of Australians with asthma had taken a respiratory medicine in the last 2 weeks , a decrease from 43% in 2011─12 . These medicines may have been used to treat asthma or another respiratory condition, as most of the medicines used for asthma are also used for patients with other chronic lung diseases, in particular chronic obstructive pulmonary disease (COPD).
The overall goals of using medications to treat asthma are to:
Different asthma medicines are used to achieve these goals, as follows:
There are clinical guidelines to help doctors and patients to best manage asthma. These guidelines include recommendations for effective use of medications.
For more detailed information about medicines used to treat asthma, refer to the Australian Asthma Handbook, Version 1.3, which provides Australia’s national guidelines for asthma management , Respiratory medication use in Australia 2003–2013: treatment of asthma and COPD , and Asthma in Australia 2011 .
People with asthma require admission to hospital when flare-ups or 'attacks' are potentially life-threatening or when they cannot be managed at home or by a GP.
Data from the AIHW National Hospital Morbidity Database (NHMD) show that in 2015–16, there were 39,448 hospitalisations where asthma was the principal diagnosis. The rate of hospitalisations for asthma was 169 per 100,000 population. The rate among children aged 0–14 (442 per 100,000 population) was markedly higher than the rate among people aged 15 and over (98 per 100,000 population).
Over the 10 years to 2015–16, the age-standardised rate of hospitalisations for asthma for children aged 0–14 decreased overall, falling from 539 to 442 per 100,000 population. Over the same period, the age-standardised rate of hospitalisations for asthma for those aged 15 and over fluctuated between 88 and 102 per 100,000 population. However, for the past two years the rate has remained steady at 98 per 100,000.
Hospitalisation rates differ by sex and age (Figure 3). In 2015–16, boys aged 0–14 were 1.7 times as likely as girls of the same age to be admitted to hospital for asthma; conversely, of those aged 15 and over, females were 2.4 times as likely as males to be admitted to hospital for asthma. These differences in hospitalisation by sex and age reflect in part the difference in the prevalence of asthma—which is more common in males than females for those under 15, and more common in females than in males for those over 15. See Prevalence by age and sex.
Source: AIHW National Hospital Morbidity Database (Data table).
Among children, the peaks for asthma hospitalisations (by admission period) occur in late summer (February) and autumn (May) (Figure 4). The peak in February is likely related to respiratory infections associated with returns to school and childcare after the summer break. This has been found during similar peaks in September in Northern Hemisphere countries; lower use of preventer medication during holidays may also contribute.
Among adults, hospitalisations for asthma are highest in winter and early spring (June through to September), particularly in people aged 65 years and older (Figure 5). This coincides with the annual winter 'flu' season and may reflect the rise in respiratory infections observed then.
Source: AIHW National Hospital Morbidity Database (Data table).
While most hospitalisations (all causes) in 2015–16 were for older people, half (51%) of the 39,448 hospitalisations for asthma in Australia were for children aged 0–14 (Figure 6). This age group was much younger compared to all hospitalisations in the same year.
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