Chronic Respiratory Conditions – Including Asthma and Chronic Obstructive Pulmonary Disease (COPD)

Mar 22, 2023 | Uncategorized | 0 comments

Chronic respiratory conditions, of which asthma and COPD are most common, are thought to affect more than a quarter of the general population of Australia.

What are chronic respiratory conditions?

Chronic respiratory conditions include asthma, allergy, hayfever (allergic rhinitis) and chronic obstructive pulmonary disease (COPD). It can be difficult to distinguish COPD from asthma because the symptoms of both conditions can be similar. The current definitions of asthma and COPD overlap. However, there are some important features that distinguish typical COPD from asthma. People with COPD continue to lose lung function despite taking medication, which is not a common feature of asthma.

Asthma

Asthma is a common chronic inflammatory condition of the airways. People with asthma experience episodes of wheezing, breathlessness and chest tightness due to widespread narrowing of the airways.

Asthma episodes can be triggered by viral infections, exposure to specific allergens, irritants such as tobacco smoke and other air pollutants, exercise and some food chemicals or additives. The underlying causes of asthma are still not well understood.

Chronic Obstructive Pulmonary Disease

COPD is a serious, progressive and disabling condition that limits airflow in the lungs. People with COPD are prone to severe episodes of shortness of breath, with fits of coughing. The terms COPD, emphysema (damaged lung tissue) and chronic bronchitis (indicated by a frequent cough caused by excessive mucus production) are sometimes used interchangeably however COPD is the current preferred medical term that includes both conditions.

COPD may also be associated with other chronic conditions such as asthma, respiratory cancers, diabetes and diseases of the heart and blood vessels due to shared risk factors and the effect of COPD on other parts of the body. Top of page

How common are chronic respiratory conditions?

In 2014-15, 7.1 million Australians were estimated to have a chronic respiratory condition, according to self-reporting in the National Health Survey (NHS). This includes nearly 2.5 million people with asthma, around 600,000 people with COPD, 4.5 million people with allergic rhinitis (hayfever) and 1.9 million people with chronic sinusitis (source 1).

There is no significant difference between the numbers of males and females estimated to have a disease of the respiratory system.

Asthma

In 2014-15 around 2.5 million people (10.8%) reported having asthma. In 2014-15, asthma was more common in women in all age groups above 15 years. (source 1).

In 2015, there were 410 deaths due to asthma, which represents 0.3% of all deaths in that year. (source 2).

In 2012–13, about one in six (18%) Aboriginal and Torres Strait Islander people reported having asthma. Asthma also was more common among people living in socioeconomically disadvantaged localities compared with those in the least disadvantaged localities (source 3).

COPD

In 2014-15 more than 600,000 Australians (2.6%) reported having COPD with the condition being slightly more common in males (301,500) than females (297,900). (source 1).

In 2015, there were 7,991 deaths due to COPD, which represents 5% of all deaths in that year.(source 2) COPD was the 3rd leading cause of death worldwide in 2010 with deaths tending to be highest in the late Winter months (July-August) in Australia. (source 3). It should be noted, however, that the attribution of cause of death in the elderly is often difficult, particularly in relation to COPD and asthma.

From 2007 to 2011, the mortality rate among Indigenous Australians was 2.6 times that of non-Indigenous Australians. (source 3). Similarly, Indigenous Australians were nearly 3 times more likely to die from COPD as non-Indigenous Australians during the period 2007-2011 (source 3).

Between 1979 and 2011, deaths due to COPD approximately halved for males while for females the rate increased between 1979 and 1997 and then declined. For people aged 55 and over, mortality rates increased with remoteness, with the highest rates in remote/very remote areas. The rate among Indigenous Australians was 2.3 times that of non-Indigenous Australians. (source 3).

What are the risk factors for chronic respiratory conditions?

Tobacco Use.

Tobacco use is the predominant cause of COPD [4] and may account for as many as 8 out of 10 COPD-related deaths [5]. Findings from the Australian Institute of Health and Welfare Australian Burden of Disease Study 2011also revealed that tobacco use was responsible for 75% of the burden for COPD.[6] [7]. The best way to prevent COPD is to avoid exposure to tobacco smoke.

Asthma

The underlying causes of asthma are still not well understood, although there is evidence that factors which increase the risk of developing asthma include environmental and lifestyle factors, as well as family history, gender and genetic factors such as an allergic tendency. Smoking and obesity are also linked to asthma development.

COPD

Advancing age is the major, non-modifiable risk factor which contributes to the development of COPD. COPD mainly affects middle aged and older people, while asthma affects people of all ages. In addition to tobacco use, other factors affecting the development of COPD include long term exposure to lung irritants such as fumes, dust and other air pollutants. According to the 2014–15 National Health Survey (NHS), people with self-reported COPD were more likely to be current smokers, physically inactive and/or obese, compared to those without COPD. Top of page

Treatment or management of chronic respiratory conditions

Asthma

General practitioners play a central role in the management of asthma in the community. This includes assessment, diagnosis, prescription of regular medications, provision of written action plans, and regular review as well as managing acute exacerbations. The Asthma Cycle of Care is a program through which doctors help patients with asthma manage their condition, and provides a framework for ongoing care and regular review.

The writing of an asthma action plan is a key part of the National Asthma Council Australia’s guidelines for the management of asthma. Asthma action plans are prepared for patients with asthma by a health care professional. Written asthma action plans can help people with asthma to manage their condition and reduce the severity of acute asthma episodes. According to self-reporting in the 2014-15 National Health Survey, an estimated 28% of people with asthma have a written asthma action plan (source 1).

People with asthma require admission to hospital when flare-ups or ‘attacks’ are potentially life-threatening or when they cannot be managed at home or by a GP.

A wide range of information and resources relating to the treatment and management of asthma can be found at the Asthma Australia website and at the National Asthma Council Australia website. This includes resources for Aboriginal and Torres Strait Islanders and those of culturally and linguistically diverse backgrounds.

COPD

Management of COPD is mainly focused on slowing or preventing disease progression and maintaining function and quality of life for people with the disease.

General practitioners are often the first point of contact for people who develop COPD. Management of COPD is mainly focused on slowing or preventing disease progression and maintaining function and quality of life for people with the disease. Strategies employed include smoking cessation, treatment with medications, oxygen therapy and pulmonary rehabilitation. Patients who experience severe COPD may require admitted hospital care.

Information and resources relating to the treatment and management of COPD are available at the Lung Foundation Australia website.

Chronic respiratory condition programs and initiatives

Chronic respiratory conditions are addressed at a national level through a range of programs and initiatives that aim to support treatment and management of asthma, COPD and other chronic respiratory conditions. Significant funding is also provided to ensure that quality clinical research is conducted into chronic respiratory conditions, and to maintain national monitoring and surveillance measures.

Programs that support management and treatment of chronic respiratory conditions include:

The Medicare Benefits Schedule, which provides subsidies for patient care and includes Medicare items for the planning and management of chronic and terminal conditions. Eligible patients can also be referred by a GP for up to five Medicare subsidised allied health services that are directly related to the treatment of their chronic condition, including chronic respiratory conditions.

The Pharmaceutical Benefits Scheme continues to provide subsidies for medicines used in the treatment of chronic respiratory conditions.

Significant investments in arthritis research through the National Health and Medical Research Council (NHMRC) for research into chronic respiratory conditions. Improving the care of patients with multiple and complex chronic diseases, including asthma and COPD, has also been identified by the NHMRC as a major focus in its 2013-15 Strategic Plan.

Support and care for chronic respiratory conditions is also provided through large-scale programs. Funding has been provided to organisations such as Asthma Australia, the National Asthma Council and the Lung Foundation. Programs which provide training, support or incentives to GPs and primary healthcare services to improve management of asthma and COPD have also been funded.

Additionally, the Australian Institute of Health and Welfare is funded to support national surveillance and monitoring of asthma and other chronic respiratory conditions.

National Asthma Strategy 2018

The Australian Government supported the National Asthma Council, in partnership with Asthma Australia, to develop the National Asthma Strategy 2018 (the Strategy). The Strategy, launched on 31 January 2018 by the Hon Greg Hunt MP ─ Minister for Health, draws from best-practice understandings of optimal asthma care and management and incorporates advice from clinical and academic experts.

Aligned with the National Strategic Framework for Chronic Conditions, and the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013-2023, the Strategy outlines a targeted and comprehensive approach to optimise asthma diagnosis and management.

The Strategy aims to significantly reduce the impact of asthma and other chronic conditions on individuals, the community and the economy, and take Australia to the next stage of improvement in asthma outcomes.

The Strategy can be accessed from the National Asthma Council website at National Asthma Strategy 2018.