Look for ‘silent’ asthma patients

Doctors are urged to be alert for possible cases of asthma, after a small increase in asthma-related deaths in Western Australia last year.


New statistics from the Australian Bureau of Statistics show WA had 9% (45) of total asthma deaths nationally in 2023.

Twenty-six women and 19 males lost their lives due to asthma last year, up from 25 females and 19 males in 2022.

Nationally, asthma deaths have returned to pre-pandemic levels, according to the National Asthma Council of Australia (NAC).

It revealed that 474 asthma-related deaths recorded in 2023, up from 473 in 2022 and 355 in 2021 when deaths were down because of COVID-19 precautions.

Dr Brett Montgomery, a Perth GP and member of the NAC guidelines committee, said that with asthma being such a common condition, GPs had a vital role in diagnosis and management.

“Diagnosing involves being alert to possible cases of asthma based on history and examination, and facilitating lung function testing,” he said.

WA women aged over 75 are still the most at risk, with 35% of all asthma deaths coming from this age group.

Deaths of females aged 0-54 years increased from one in 2022 to 6 in 2023 but remained steady across all other female age groups.

In men, there was a small increase in deaths among those aged 0-54 year and 55-74 years, however there was a slight drop in male deaths aged over 75 years from 12 in 2022 to 9 deaths last year.

The NAC said serious ongoing problems with asthma management were to blame.

NAC Director and respiratory physician, Professor Peter Wark, said more effort was needed to diagnose asthma properly and emphasise to patients living with asthma the importance of using an inhaled preventer treatment.

“Asthma is a chronic disease of inflamed airways and needs to be treated with an anti-inflammatory corticosteroid preventer to control symptoms and reduce asthma deaths, not just use of a blue reliever puffer alone. But this preferred option is still under-prescribed in Australia.

“This is despite its recommendation as the preferred treatment in the NAC’s Asthma Handbook, the national guidelines for the diagnosis and management of asthma as a chronic condition.”

Dr Montgomery added that many patients come to accept a certain level of symptoms by using short-acting reliever puffers rather than preventer inhalers.

“By identifying such patients, and persuading them to change towards better prevention, GPs may make a real difference to asthma outcomes,” he said.

“The lack of use of effective prevention has been a stubborn problem for many years, but the new strategy of ‘anti-inflammatory relievers’ combining corticosteroid and formoterol gives me hope.

“With this, we may help our more symptom-driven patients to achieve better asthma control and less risk of dangerous outcomes.”

https://www.asthmahandbook.org.au/