Asthma management: how effective is it in the community?

The National Asthma Campaign (NAC) was launched in Australia in 1989 with the major objective of improving asthma management through the implementation of a six-step asthma management plan.

The objective of the present study was to analyse the management of asthma in a cohort of adults with self-reported asthma 10 years after the commencement of the NAC.

The subjects were participants in the laboratory phase of a cross-sectional epidemiological study conducted in Melbourne in 1999-2000. Participants completed the detailed European Community Respiratory Health Survey, which included specific questions about their asthma management. Participants were included in this analysis if they had a positive response to the question 'Have you ever had asthma?'. This resulted in a total of 435 subjects.

Of the subjects with self-reported asthma, over half of the participants reported that a doctor had ever measured their breathing (52.9%). However, only 10.1% of participants reported that they owned a peakflow meter (PFM) and only 13.3% reported that they had ever been given a written action plan. In comparison with data reported from 1993, doctor measurement of lung function has decreased significantly (P < 0.000 1), as has PFM ownership (P < 0.0001) and, importantly, possession of a written action plan (P = 0.0004).

Asthma management among adults still falls well short of NAC guidelines. The decline in some key features over recent years suggests that new management and dissemination strategies are required.