FAQs

Up to 80% of patients with asthma have rhinitis.

• Effective treatment of allergic rhinitis improves asthma control and lung function.
• Intranasal corticosteroids are more effective than antihistamines in controlling symptoms of allergic rhinitis as well as non-allergic rhinitis.
• Long-term use of newer intranasal corticosteroids does not appear to affect the hypothalamic–pituitary–adrenal (HPA) axis or cause mucosal atrophy.
• Specific allergen immunotherapy is effective in the management of rhinitis and asthma and can achieve a durable remission of allergic symptoms.

Learn more

• Allergic rhinitis and the patient with asthma 
• Asthma and allergy 
• Intranasal corticosteroid spray technique for people with allergic rhinitis

Adherence to prescribed therapy is a major factor in successful asthma management. Strategies to improve adherence include:

• Ensure your patient understands their asthma and treatment
• Adopt a 'partnership approach' with your patient to their asthma management
• Simplify medication regimens, including dosing and devices
• Use reminders, e.g. take your preventer before brushing your teeth each morning and evening
• Make sure your patient can easily understand and follow their written asthma action plan
• Encourage patients to see you even when they're feeling well – adherence needs to be continually monitored over time.

Learn more

• Asthma adherence: A guide for health professionals 
• Asthma action plans 
• Australian Asthma Handbook: Assessing and maximising patients' adherence to asthma treatment

Written asthma action plans are one of the most effective asthma interventions available. Use of a written asthma action plan:

• reduces absences from work or school
• reduces hospital admissions
• reduces emergency visits to general practice
• reduces reliever medication use
• improves lung function.

Doctors should consider developing a written asthma action plan when discussing asthma management with all people with asthma and/or their carers.

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Asthma action plans 

Our best-practice asthma and respiratory management education workshops for health professionals are designed for the whole primary care team.

Ensure your knowledge and skills are up to date by attending one of our free workshops, held with GP networks/divisions and Medicare Locals around the country.

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Asthma & Respiratory Education Program

Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) can provoke asthma or rhinitis symptoms in some people with asthma, yet many others can take these medications with very low risk of an asthma reaction.

The risk of a reaction to aspirin or NSAIDs is highest in:

• people with severe asthma who experience long-term nasal congestion and severely watery nose
• people with recurring nasal polyps
• people who experience sudden, severe asthma (e.g. have been admitted to intensive care with asthma)
• people who first experience asthma as adults and do not have known allergies as the cause.

All products that contain aspirin or any NSAID should be avoided by anyone who has been diagnosed with aspirin-intolerant asthma and anyone who has previously experienced runny nose or wheezing 1–3 hours after taking aspirin or NSAIDs.

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Pain relievers and asthma: a quick reference guide

Poorly controlled asthma increases the risk of pre-eclampsia, prematurity, low birth weight and perinatal mortality. However, good asthma control reduces these risks.

Most medications for asthma have good safety profiles in pregnant women. The pharmacological treatment of asthma during pregnancy should be the same as for non-pregnant women. If oral corticosteroids are clinically indicated for an exacerbation they should not be withheld because a woman is pregnant.

Learn more

Australian Asthma Handbook: Asthma in pregnant women

Milk consumption does not lead to mucus production or occurrence of asthma. Findings from one group even suggest that there may be an association between increased milk intake and reduced incidence of asthma symptoms in children.

Food allergens are uncommon triggers for asthma in any age group; as few as 2.5% of people with asthma react to foods in blinded challenges. Most people with asthma can regularly include dairy in their diet, unless an allergy to cow’s milk is proven.

Learn more

• Australian Asthma Handbook: Healthy eating for asthma
• Wuthrich B, Schmid A, Walther B, Sieber R. Milk consumption does not lead to mucus production or occurrence of asthma. J Am Coll Clin Nutr 2005; 24: S547–55. 
• Wijga A, Smit H, Kerkhof M, et al. Association of consumption of products containing milk fat with reduced asthma risk in preschool children: the PIAMA Birth Cohort Study. Thorax 2003; 58: 567–72. 

Aerosol inhalers such as metered dose inhalers (MDIs) are formulated with drug particles and propellants in a dispersion. To facilitate delivery to the lower airways, the particles need to be of small size (i.e. 2–5 microns) and to have sufficient kinetic energy. Each drug particle needs to be coated with propellant, which will later evaporate and impart the required kinetic energy to the particle.

The purpose of shaking is to ensure that the dispersion is uniform and that each drug particle is coated with propellant. Learn more

Inhaler use in adults with asthma or COPD 

Medication delivery via nebuliser is no longer recommended for routine asthma care.

A growing number of systematic reviews have found that a metered dose inhaler (MDI) plus a large volume spacer is at least as effective as nebulisation for treating asthma in almost all circumstances, including mild to moderate acute exacerbations. In addition, patient over-reliance on nebulisers during an acute episode may delay effective treatment and increases the risk of life-threatening asthma.

Not only is an MDI plus spacer more convenient and cost effective than a nebuliser, it is also easier to use and maintain and has fewer side-effects.

Nebulisation should be reserved for patients with severe or life-threatening asthma requiring continuous oxygen and salbutamol. It should be considered for self-management (e.g. for patients with complex comorbidities) only in exceptional circumstances.

Learn more

• Australian Asthma Handbook: Inhaler devices and technique
• Cates CJ, Bara A, Crilly JA, Rowe BH. Holding chambers versus nebulisers for beta-agonist treatment of acute asthma. Cochrane Database Syst Rev. 2006; (2):CD000052  
• Cates CJ, Bestall JC, Adams NP. Holding chambers versus nebulisers for inhaled steroids in chronic asthma. Cochrane Database Syst Rev 2006; (1): CD001491.

The whole of Australia is an asthma zone – asthma prevalence is similar across the country, although perhaps slightly higher in rural areas than urban.

Local asthma issues are very much dependent on the local allergens such as pollens, grasses, moulds and house dust mites. Coastal cities tend to have higher dust mite levels, particularly if they have humid climates, but the inland regions, while drier and with lower dust mite levels, have many types of pollens and moulds that can trigger asthma.

Learn more

Australian Centre for Asthma Monitoring