newsGP – Navigating the Recent Growth in Asthma Drugs

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The National Asthma Council Australia has launched new resources to help educate healthcare professionals about treatment options.

There are an increasing number of asthma inhalers and devices becoming available.


According to the director of the National Asthma Council Australia and respiratory physician, Professor Peter Wark, there has recently been an ‘explosion’ of medicines available for people with asthma.


But while the choice is welcome, it has made it harder for time-strapped clinicians to keep up to date with the latest drugs and their indications, which is why the council has released a new set of resources to help practitioners to determine the best treatment option.


The first resource is a chart which provides a visual drug reference for each level of the diagram from the Australian Asthma Handbookwhich is designed to help health care providers when selecting and adjusting medications for adults and adolescents.


“The chart is popular with GPs and pharmacists because it… [are] so many different inhalers and devices on the market,” Professor Wark said.


“This is a real challenge and can be confusing for patients and healthcare workers.


“This board now brings together all the information in a visual format about medications and when they are used, in one place for quick reference.


“We hope that GPs and pharmacists will use this visual aid to help patients understand the place of their treatment and to reinforce the important place of preventive treatment in the care of almost all people with asthma.”


The second resource is an updated version of medication chart for asthma and chronic obstructive pulmonary disease (COPD)which offers a guide to the main types of asthma and COPD medication available in Australia.


The updated version also clarifies the Pharmaceutical Benefits Scheme (PBS) reimbursement status of each drug as of April 2022.


The chart provides a quick reference guide that addresses the best approach to asthma and COPD and when to use the right inhalers at the right time, Professor Wark explained.


“This is a useful educational resource for healthcare professionals to help identify and explain different treatments,” he said.


“It’s such a changing environment and keeping up to date is a major challenge, so it’s important for GPs and pharmacists to keep up to date with new medicines as well as existing medicines that have changed packaging or branding. .”


According to Professor Nick Zwar, Chair of the National Asthma Council Australia Guidelines Committee, the number of long-acting muscarinic antagonists (LAMAs) has also recently increased and there is a need to clearly present the range of treatment options. single-page processing. document.


“Before it was just tiotropium and now there’s umeclidinium, aclidinium and glycopyrronium,” he said. newsGP.


“These are three additional LAMAs that have only been available fairly recently to treat harder-to-control asthma.”


The importance of presenting information visually should also not be overlooked, according to Professor Wark.


“Even when patients can’t remember the name of their inhaler, they will recognize it,” he said.


“They can see where it needs to be placed in therapy and it’s also a big help for those whose first language is not English.


The problem of rapidly increasing numbers of LAMAs, inhaled corticosteroids (ICS), long-acting beta-agonists (LABAs), and combinations of these drugs is compounded by the fact that the same drug is showing up often in a variety of devices.


Prof Wark said choosing the most appropriate device should be a ‘collaborative effort’ between the patient and their GP.


“It is very important that the patient uses a device that he is comfortable with and that he likes. This has been shown to very clearly influence their adherence to this device,” he said.


“Using the devices themselves is complex and requires training, education and support for the patient – ​​and that support often has to be an ongoing thing.


“If someone is installed on a certain type of device and shown how to use it, changing that device can be quite disruptive. It’s a challenge in the breathing space.


In addition, the diagnosis of asthma has always been difficult because it usually requires pulmonary function tests and spirometry to demonstrate reversible airflow obstruction.


“This test is time consuming, it is not well reimbursed and GPs are often unfamiliar with its interpretation,” Prof Wark said.


“There has been an underuse of testing and as a result this has led to both underdiagnosis and overdiagnosis of asthma. And, sometimes, inappropriate use of medication.


These challenges have been further heightened by the pandemic as there is a risk that these procedures will generate aerosols.


“There was a very long period where virtually no lung function [testing] was happening,” Professor Wark said.


“There has been some backtracking to start over, but in many cases there is still a reluctance in primary care to reintroduce spirometry, in part based on these [COVID-related risks].


“Although there are alternative diagnostic tests, such as expired nitric oxide, these are less well known and less equipment available in Australia.”



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