One in four people with asthma are missing out on preventer treatment

Widespread poor asthma management is putting the health of thousands of Kiwis at risk, new research shows.

Asthma affects up to 20 per cent of New Zealanders. We have the highest rate of asthma, and one of the highest hospital admission rates for asthma, in the OECD.

These statistics drove New Zealand medicines data research company Matui to examine medicines information from 330,000 people under 50 years dispensed asthma inhalers in the previous 12 months or admitted to hospital with asthma.

What they discovered was troubling, but largely preventable.

Matui found about 25 per cent (one in every four people) aged 12 and older did not receive treatment that best reduces their risk of future severe asthma attacks that could lead to hospitalisation or death.

Those 25 per cent only received SABA inhaler medication (known as short-acting beta2 agonists) designed to bring short-term relief.

The most recent New Zealand Adolescent and Adult Asthma Guideline released by the Asthma and Respiratory Foundation NZ state that this treatment approach is not longer recommended in the long-term management of asthma in adolescents and adults.

The Guidelines introduced a fundamental shift in asthma treatment, with a specific 2 in 1 combination (preventer and reliever) inhaler recommended for most patients aged 12 years and over, instead of separate preventer and reliever inhalers.

Matui researcher Noni Richards says: “As someone with asthma myself, I feel frustrated that not all people with asthma receive the care I do.”

Māori with asthma at greatest risk

Dr Richards says national data indicates we still have some way to go to achieve equitable asthma outcomes for all patients in New Zealand.

“There is a lot of evidence that demonstrates that Māori with asthma are more likely to be hospitalised or die due to asthma than European or other ethnicities.

“Despite this, Māori with asthma are less likely to be prescribed preventer inhalers or to have an action plan or receive adequate asthma education.”

Asthma continues to be inadequately managed and likely poorly controlled generally in the community, too, adds Dr Richards.

“People aged over 12 years continue to be prescribed (or only pick up) SABA inhalers without maintenance treatment, and many people are dispensed excessive numbers of SABA inhalers in the year.

“While this does not necessarily reflect exactly how people are managing their asthma, we know both measures are risk factors for severe attacks, hospital admissions and mortality.”

The Matui team encourages everyone with asthma to ask their GPs about an asthma action plan.