Showing posts with label preventable deaths. Show all posts
Showing posts with label preventable deaths. Show all posts

Thursday 30 November 2023

Asthma deaths on the rise again and many deaths were preventable according to the National Asthma Council Australia

 

At the 2021 Australian Census 625,835 people reported Asthma as a long-term health condition - with a population incidence rate of 8.2%.


In New South Wales, Asthma was the fourth highest long-term condition category self-reported in the Census results.


Asthma was also the third highest long-term health condition category recorded in the Clarence Valley, Richmond Valley & Lismore City local government areas and, the fourth highest in Tweed Shire, Ballina Shire, Bryon Shire & Kyogle Shire local government areas.



National Asthma Council Australia, media release, 29 Nov 2023:


Asthma deaths on the rise again, but could be avoided


The National Asthma Council Australia said that the tragic deaths of hundreds of Australians each year could be avoided, but the key is correct diagnosis, the use of inhaled corticosteroid preventers and, where control of asthma cannot be achieved, referral to a specialist for consideration of a biologic.


According to new Australian Bureau of Statistics (ABS) data released today by the National Asthma Council Australia, asthma deaths are once again on the rise, with a jump of over 30% in asthma deaths in one year.


The figures show that there were 467 asthma-related deaths recorded in Australia in 2022, made up of 299 females and 168 males, up from 355 deaths in 2021.


Deaths were down in 2021 as a result of the precautions in place and the lockdowns that occurred with the COVID-19 pandemic. This led to fewer respiratory infections and fewer asthma exacerbations. Asthma exacerbations have now returned to pre-pandemic levels and may even be slightly higher.


National Asthma Council Australia Director and respiratory physician, Professor Peter Wark, said each year, for the past ten years, around 450 Australians lost their lives due to asthma.


Sadly, this is of no surprise and reflects the problems with asthma care in Australia.


What is of most concern is that most of these deaths are preventable and many relate to undertreatment, especially in regard to the use of inhaled corticosteroids. Confusion around asthma diagnosis is also a major limitation to optimising asthma care and if anything has worsened with the with less spirometry being performed than ever before.


Advising and committing people to regular treatment for asthma requires an investment in time and effort to correctly diagnose asthma and lung function testing is an essential part of accurate asthma diagnosis,” he said.


Professor Wark said that inhaled corticosteroids remain the only treatment that clearly reduce acute asthma exacerbations and asthma mortality for people in all asthma age groups six years and older and should be used in the majority of people with asthma.


However regular prescriptions for inhaled corticosteroids occur in less than a third, while adherence to regular therapy remains an important problem,” he said.


Uncontrolled over the counter use of salbutamol encourages inappropriate use of relievers to the detriment of the use of preventers and has been strongly associated with an increased risk of asthma death.


In addition there is still limited use of as needed inhaled corticosteroid/formoterol for people with mild asthma as recommended by the Australian and international guidelines as being just as effective as regular inhaled corticosteroids and much more effective and safer than using relievers alone.


This more flexible approach to treatment is ideally suited to people with mild asthma, many of whom are now at risk because they are not using an inhaled corticosteroid preventer.


Until these issues are addressed, we will not see improvements in asthma admissions or mortality,” said Professor Wark.


The ABS statistics also show that once again, women over 75 are still the most at risk, with almost half (45 per cent) of all asthma deaths coming from this age group.


Adult onset asthma or a return of asthma symptoms in adults is associated with more troublesome asthma that is more severe and more difficult to control and affects more women than men. Women tend to require higher doses of inhaled corticosteroids, suffer more frequent attacks with worse day to day asthma control.


Asthma is also a chronic disease, present irrespective of symptoms and is associated with other chronic conditions that impact on an individual’s health, in particular obesity, reduced aerobic activity and other chronic illnesses,” he said.


The ABS 2022 data also showed that male deaths increased in almost every age group and jumped from 109 (2021) to 168 (2022) - the highest number of male deaths in the last 10 years.


Professor Wark said that while asthma risk is greater in women, men are also affected and also experience poor asthma control and exacerbations.


At least in some asthma cohorts, men who experience asthma attacks were less adherent to regular asthma preventer treatment and were less likely to attend their doctor for poor asthma control compared to women. Factors that would both contribute to an increase in exacerbations and increase the risk of mortality,” he said.


Link to 2022 mortality infographic here.


Click on image to enlarge