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Australian Journal of Pharmacy : February 2005
asthma Australian asthma deaths down by 21 per cent F EWER Australians are dying from asthma, with the number of deaths from the condition falling to 314 in 2003 from 397 in 2002. This equates to a substantial decrease of 21 per cent, according to the Australian Bureau of Statistics. The National Asthma Council’s CEO, Kristine Whorlow, said the reduction in deaths was consistent across all age groups. ‘In the under 35 age group, there were 25 per cent fewer deaths from asthma last year,’ she said. ‘The 65 and over group reported a 26 per cent reduction. However, 64 per cent of all asthma deaths last year were from this category.’ According to the Asthma in Australia report, although most deaths due to asthma occur in the elderly, the diagnosis of asthma as the cause of death as opposed to other respiratory disease, is unreliable for this age group. It is still unknown if this trend among older people represents a real difference in asthma mortality risk or if it indicates the diagnostic of labeling preference of medical practitioners. ‘The trouble with diagnosis of death in the older person is that there might be other respiratory conditions there as well so it is a little hard to sometimes to know what the older person died of—whether it is smoking related diseases like COPD, for example,’ Ms Whorlow said. ‘However, we can still be pleased that we are managing to bring the death rate in asthma down for all age groups,’ she said. completed according to the HIC data. However, not all would have been claimed for. ‘It’s always difficult in Australia to get patients to go back to their doctor for each visit they need and that doesn’t just relate to asthma—that’s for every condition we have,’ Ms Whorlow said. ‘We know that there has been a prob- lem getting people back for their three vis- its and that’s where the pharmacists pro- gram is so important because pharmacists can encourage people to do that. ‘The pharmacist has potential to deliver lots of important messages about asthma.’ Boosting pharmacy assistant’s role Meanwhile the NAC’s Pharmacists Asthma Group has been attempting to develop a greater involvement of phar- macy assistants in asthma management, with a focus on the devices not the med- ication. ‘That has been less than satisfactorily resolved by the pharmacy groups—the Society and the Guild,’ Mr Appel said. ‘They have not been positively anti— it’s because they have had other things to do. ‘The Guild has completely reviewed its pharmacy assistant training package and done a terrific job, and we were hoping to have included in that a module for accred- itation for pharmacy assistants in relation to asthma devise management, but that hasn’t eventuated. ‘So we are still knocking on the doors and we will continue to do so,’ he said. Mr Appel said pharmacy assistants could easily take charge of the manage- ment of asthma devices—the use of them, the cleaning of them and the maintenance of them. ‘Pharmacists don’t have time to be doing all that but a well-trained pharmacy assistant, a senior assistant who is identi- fied as being caring and professional, would be very, very useful in making sure people are using asthma devices cor- rectly,’ he said. Mr Appel said the Asthma Founda- tion’s new training programs for phar- macy assistants would be of considerable 94 ? THE AUSTRALIAN JOURNAL OF PHARMACY VOL.86 FEBRUARY 2005 benefit to those who took it up. ‘It would be good if that were to be sup- ported/endorsed by pharmacy groups because at the moment there is not a for- mal training program for pharmacy assis- tants,’ he said. ‘We think that’s a very useful option for pharmacy to have because we are con- fronted with a lot of mismanagement of asthma—the NAC has been very success- ful in lowering the mortality due to asthma—it is the management that we need to focus on more and more,’ he said. He said pharmacists and pharmacy assistants were well placed to offer advice on asthma management. ‘They are at the coalface. However, community pharmacists have many tasks to attend to nowadays and the more we can farm out to pharmacy assistants, the better. ‘Pharmacy assistants are being recog- nised through the Quality Care Program as being very able to take responsibility for extended roles and we think this is an opportunity which as yet not been fully realised,’ Mr Appel said. s