Asthma

Introduction

Asthma is a chronic inflammatory disorder of the airways in which, in response to a wide range of triggers, the airways narrow too much and too easily, resulting in episodes of wheeze, chest tightness, and shortness of breath. The prevalence of asthma is relatively high in Australia by international standards.[1-3]

The effects of asthma can include: disturbed sleep, tiredness, and reduced participation in the workforce and organised sport and other activities. Asthma ranks among the top 10 problems managed by general practitioners and is a major cause for hospital admission in children.[1-3]

Asthma is not curable but can be managed effectively. Current recommended management strategies include: increased use of preventer medications, reduced use of reliever medications, use of a structured or written asthma management plan, avoidance of known triggers, and regular review by a general practitioner. Research has shown most patients with an asthma management plan found it useful for managing their asthma.[4-6]

In 2006, the New South Wales Population Health Survey asked respondents: Have you ever been told by a doctor or hospital you have asthma? Have you had symptoms of or treatment for asthma in the last 12 months? What are the names or brands of all the [preventer or reliever] medications you took for asthma in the last 12 months? Do you have a written asthma management plan from your doctor on how to treat your asthma? During the last 4 weeks did your asthma interfere with your ability to manage your day-to-day activities?; Did it interfere with these activities: A little bit, Moderately, Quite a bit, Extremely?

Results

Ever had asthma

Overall, in 2006, 19.3 per cent of adults had ever being told by a doctor or hospital they had asthma. There was no significant variation between males and females. A significantly higher proportion of adults aged 16-24 years (23.7 per cent) and 25-34 years (25.5 per cent), and a significantly lower proportion of adults aged 65-74 years (15.4 per cent) and 75 years and over (13.0 per cent), ever had asthma. A significantly higher proportion of adults in rural areas (21.8 per cent) than urban areas (18.2 per cent) ever had asthma. A higher proportion of adults in the Greater Western Health Area (24.6 per cent) ever had asthma. There was no variation by level of socioeconomic disadvantage. The proportion of adults who ever had asthma has increased significantly between 1997 (16.8 per cent) and 2006 (19.3 per cent). This increase was significant in males (15.2 per cent to 18.4 per cent) but not in females (18.4 per cent to 20.1 per cent).

Currently have asthma

Overall, in 2006, 10.9 per cent of adults currently have doctor-diagnosed asthma. A significantly higher proportion of females (11.8 per cent) than males (9.9 per cent) currently have doctor-diagnosed asthma. There was no significant variation among age groups, or among health areas, or by level of socioeconomic disadvantage. A significantly higher proportion of adults in rural areas (12.7 per cent) than urban areas (10.1 per cent) currently have asthma. There has been no significant variation in the proportion of adults who have current asthma between 1997 and 2006.

Use of medication

Overall, in 2006, 42.4 per cent of adults with current asthma used short-acting bronchodilators, 22.4 per cent used combined inhaled steroids and long-acting bronchodilators, 9.2 per cent used inhaled corticosteroids, 0.3 per cent used cromone, 0.0 per cent used leukotriene receptor antagonists, and 2.3 per cent used oral steroids.

Overall, in 2006, among those adults with current asthma, 84.3 per cent used reliever medication (short-acting bronchodilators, long-acting bronchodilators, and combined inhaled steroids and long-acting bronchodilators). A significantly higher proportion of females (89.1 per cent) than males (78.4 per cent) use reliever medication. There was no significant variation by age group, or by level of socioeconomic disadvantage; however, a higher proportion of adults with current asthma in the Sydney West Health Area (94.6), and a lower proportion of adults with current asthma in the South Eastern Sydney & Illawarra Health Area (70.0 per cent), used reliever medication, compared with the overall adult population with current asthma.

Overall, in 2006, among those adults with current asthma, 51.2 per cent used preventer medication (inhaled corticosteroids, cromone, leukotriene receptor antagonists, oral steriods, long-acting bronchodilators, and combined inhaled steroids and long-acting bronchodilators). There was no significant variation between males and females, or by age group, or between rural areas and urban areas, or among health areas, or by level of socioeconomic disadvantage.

Written asthma management plan

Overall, in 2006, among those with current asthma, 37.6 per cent had a written asthma management plan. There was no significant variation between males and females, by age group, between rural areas and urban areas, among health areas, or by level of socioeconomic disadvantage. The proportion of adults with current asthma who have a written asthma management plan has not varied significantly between 1997 and 2006.

Interference with daily activities

Overall, in 2006, among adults who had current asthma, 82.4 per cent had no interference with daily activities, 5.4 per cent had a little interference, 6.4 per cent had moderate interference, 3.6 per cent had quite a lot of inteference, and 2.2 per cent had extreme interference.

Therefore, 12.2 per cent had moderate to extreme interference with their ability to undertake daily activities because of their asthma. There was no significant variation between males and females, among age groups, between rural areas and urban areas, or by level of socioeconomic disadvantage; however, a lower proportion of adults with current asthma in the Greater Western Health Area (6.2 per cent) had moderate to extreme interference with their ability to undertake daily activities because of their asthma, compared with the overall adult population with current asthma. The proportion of adults with current asthma who have moderate to extreme interference with their ability to undertake daily activities because of their asthma has decreased significantly between 1997 (22.6 per cent) and 2006 (12.2 per cent). This decrease was significant in females (26.8 per cent to 12.8 per cent).

Current smoking

Overall, in 2006, among adults with current asthma, 19.0 per cent were current smokers. There was no significant variation between males and females. A significantly lower proportion of adults with current asthma aged 55-64 years (10.0 per cent) and 65-74 years (7.7 per cent) and 75 years and over (5.4 per cent) were current smokers. There was no significant variation between rural areas and urban areas, or among health areas, or by level of socioeconomic disadvantage.

References

Australian Government Department of Health and Ageing. Health Insite: Asthma website at www.healthinsite.gov.au/topics/asthma (accessed 10 May 2007).
Australian Centre for Asthma Monitoring. Asthma in Australia: Findings from the 2004-05 National Health Survey. Sydney: Australian Centre for Asthma Monitoring, 2007. Available online at www.asthmamonitoring.org (accesssed 10 May 2007).
Australian Centre for Asthma Monitoring. Survey questions for monitoring national asthma indicators. Sydney: Australian Centre for Asthma Monitoring, 2007. Available online at www.asthmamonitoring.org (accesssed 10 May 2007).
Australian Centre for Asthma Monitoring. Patterns of medication use in Australia. Sydney: Australian Centre for Asthma Monitoring, 2007. Available online at www.asthmamonitoring.org (accesssed 10 May 2007).
Gibson PG, Coughlan J, Wilson AJ et al. Self management education and regular practitioner review for adults with asthma. Cochrane Database of Systematic Reviews. Oxford: John Wiley & Sons, 2006. Abstract and plain language summary available online at www.cochrane.org/reviews/en/ab001117.html (accessed 10 May 2007).
Douglass J, Aroni R, Goeman D, Stewart K, Sawyer S, Thien F, Abramson M. A qualitative study of action plans for asthma. BMJ 2002; 324: 1003. Abstract available online at www.bmj.com/cgi/content/abstract/324/7344/1003 (accessed 10 May 2007).

Graphs

Source:	New South Wales Population Health Survey 2006 (HOIST). Centre for Epidemiology and Research, NSW Department of Health.
Print version:	Although this page can be printed directly from your web browser, a higher quality version is available as a PDF file that can be printed or viewed on screen.
Produced by:	Centre for Epidemiology and Research, Population Health Division, NSW Department of Health.
Last updated on:	1 July 2007