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NZers To Benefit From New Adult Asthma Guidelines




New best practice, evidence-based guidelines for the diagnosis and treatment of adults with asthma were launched at the College of General Practitioner’s Conference in Rotorua today.

Asthma is an inflammatory disorder of the airways associated with variable airflow obstruction. This form of breathing restriction is one of the most common health problems affecting New Zealanders – with approximately 15% of adults reporting asthma symptoms.

The aims of asthma treatments recommended in the guideline are to:
- control symptoms,
- reduce inflammation of the airways, and
- maintain the best possible lung function.

The New Zealand Guidelines Group (NZGG) asthma guideline provides health providers and individuals with asthma with independent advice about the most effective treatment options for managing mild to moderate asthma, as well as acute and severe asthma attacks. “Our recommendations aren’t around promoting asthma medications or products, rather we have taken an impartial look at what works best”, said Dr Peter Didsbury, one of the leaders of the guideline team.

“For example, a large proportion of people in NZ get asthma as a result of an allergy. However, the evidence shows that only a few people will benefit from installing air filters and steam cleaning carpets or getting rid of furnishings and pet hair. Skin prick testing to identify the allergen, is probably the first thing that should be checked out – followed by immunotherapy if an allergen is idenitified”, said Dr Didsbury.

The guideline team also emphasize that it is important that each individual understands how to, and is empowered to, manage their asthma. Tools such as a personal asthma management plan are important so that people can record their peak flow readings, and identify any warning signs. Annual reminders about the most effective ways of using puffers, spacers and asthma medications are also highly recommended.

The guideline also provides detailed recommendations about the use of the latest medications. “We now have new classes of drugs including long-acting beta-agonists (LABAs), leukotriene receptor antagonists (LTRAs) and combination agents which not all doctors will be familiar with”, said Professor Ian Town, the co-leader of the guideline team. The guideline provides details of those treatments that are proven to be effective for different levels of severity of asthma.

“The unique thing about this guideline is that we have researched the issues of concerns for people with asthma. They tell us they are concerned about the accumulated doses of steroid and other medications they take to control or treat their asthma. So we have looked at the evidence for prescribing the lowest, most effective dose levels which will keep a check on their symptoms”, he said.

The NZGG adult asthma guideline has been an example of tremendous team work and collaboration with the focus on identifying the best treatments for people with asthma. We have been very pleased to have a broad range of experts involved on the team - general practitioners, respiratory physicians, respiratory and primary care nurses, a consumer, Maori perspectives, asthma researchers and a pharmacist facilitator”, said Professor Town.

The guideline team has worked together over the last two years to develop the guideline. This has involved in extensive, painstaking, rigorous analysis of national and international studies on the effectiveness of the treatment/ service. Maori perspectives have been specifically included so that the guideline is of particular relevance for New Zealanders. “We have had tremendous feedback and support from organizations endorsing this guideline such as the Royal New Zealand College of General Practitioners, Aotearoa (NZ) College of Nurses, the Royal Australasian College of Physicians (NZ), the New Zealand branch of the Thoracic Society of Australia and New Zealand, the Asthma and Respiratory Foundation, Tu Kotahi Maori Asthma Society, Respiratory Nurses of NZ, Sports Medicine NZ and the Canterbury Asthma Society. They strongly support the approach of the new guidelines and believe that the guideline recommendations will result in major improvements in care for the thousands of New Zealanders with asthma,” said Ian Town.

The Royal New Zealand College of General Practitioners Conference is being held at the Rotorua Convention Centre on 26 – 28 September 2002. The guideline is being launched at 1.00pm on Friday 27 September by Steve Chadwick MP.

The New Zealand Guidelines Group (NZGG) is a not-for-profit, non-government organization, set up to promote evidence-based effective health and disability services.


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