Are your patient’s asthma ready for winter?

Colds and flu = flare-ups

Health Professionals and care providers are an important support for people with asthma in helping ensure they are ‘asthma ready’ for the winter colds and flu season.

Refer your patients

Refer your patients to our Patient Education Referral Service. This telephone service, delivered by 1800 ASTHMA Helpline staff, aims to work with the referrer to achieve improved asthma control in patients by providing additional evidence-based asthma self-management education, support and goal setting.

Click here to refer your patients now!

How do colds and flu impact asthma?

Colds and flu can be more serious for people with asthma. The reasons for this are not fully understood, however we do know that people with asthma have swollen and sensitive airways, and it is thought that colds and flu can cause further swelling of the airways, which can trigger asthma flare-ups and a worsening of asthma symptoms. 
Even if asthma is mild or symptoms are well-controlled by medication, at times, it is possible to still experience break-through symptoms especially if unwell with a cold or flu virus. 
Among adults, emergency department presentations and hospitalisation rates for asthma are highest during the winter months and early spring (June through to September), which most likely reflects the rise in respiratory infections during this time. 

People with asthma who contract influenza (flu) are at higher risk of experiencing complications. These complications can include:

  • more severe asthma flare-ups,
  • pneumonia, bronchitis, ear infections,
  • days lost from work and school,
  • hospitalisation and even death.

Asthma Australia surveyed over 500 people with asthma and their carers to better understand their personal experiences of asthma and how it is affected during the cold and flu season. Survey respondents told us that colds and flu mean: 

  • Increased asthma symptoms
  • Increased reliever medication
  • Visit doctor
  • Course of oral corticosteroids
  • Day off work/school/study

How can health professionals help patients be prepared for the cold and flu season?

Cold and flu viruses are very common triggers for people with asthma, and although they can’t always be avoided, patients can lower their risk of a flare-up and the impact a cold or flu virus can have on their level of asthma control.

Good asthma management year-round is key to ensuring people with asthma are ready for the winter cold and flu season. Here are some key asthma management tips to ensure your patients are asthma ready this winter.

Encourage regular asthma reviews

A survey of Australians aged 16 and older with current asthma, identified that 29% had needed urgent health care for asthma in the previous year [2]. Of these, 23% had urgent need to see their GP, 10% their emergency department or hospital, with 4% needing one or more nights in hospital because of their asthma.

As asthma is variable and can change over time, people with asthma should see their doctor at least every 6-12 months, to assess recent asthma symptom control and identify risk factors that predict poor asthma outcomes, as both are components of overall asthma control.

With your patient:

  • assess their current level of asthma control 
  • assess each patient’s risk of future asthma events or adverse treatment effects 
  • review current treatment, including adherence to preventer if prescribed
  • check their inhaler technique  
  • provide a written Asthma Action Plan or review and update their current plan.

Provide education to your patient on how and when to use their Asthma Action Plan. Discuss any problems or issues the person is having with their asthma

See the Australian Asthma Guidelines for more information on conducting an asthma review at scheduled asthma visits. Click here for adults and click here for children.

Assess level of asthma control

Poor asthma control (frequent symptoms and/or flare-ups) is a common problem in both adults and children. Research has found that for almost half of people with asthma, there is a gap between the potential control of their asthma symptoms and the level of control they currently experience.

If your patient has experienced any of the following in the last four weeks it indicates their asthma may not be under good control.

  • daytime asthma symptoms more than 2 days per week
  • need for reliever more than 2 days per week
  • any limitation on activities due to asthma symptoms 
  • any asthma symptoms during the night or on waking

Assess level of asthma control using the Asthma Control Test™ (ACT) or Primary care Asthma Control Screening tool (PACS). Click here for more information and to access these Asthma Control Questionnaires.

Review treatment

Most adults and adolescents with asthma should have regular preventer medication, however Australian data shows that less than 20% of people are being dispensed enough preventer medication to be taking their treatment regularly. Almost 40% of people only use reliever medication, treating their symptoms but not the cause. 

Preventer is the mainstay of asthma management. Consider preventer treatment, address adherence and potential barriers if prescribed.

See: Assessing patients’ adherence to asthma treatment and Maximising patients’ adherence to asthma treatment in the Australian Asthma Guidelines.

Demonstrate and check inhaler device technique

Up to 90% of people are thought to use their inhalers incorrectly, which means the dose of medicine isn’t getting into the lungs where it’s needed. Demonstrate and check your patients inhaler technique. 

Visit the National Asthma Council Australia’s Instructional inhaler technique video library here.

Written Asthma Action Plans

Every adult and child with asthma should have their own written Asthma Action Plan however, only 1 in 5 people aged 15 and over with asthma have one.  An Asthma Action Plan provides clear instructions on how to adjust medication in response to asthma symptoms, and when and how to get medical care, including during an emergency and should be reviewed regularly.

Research shows that written Asthma Action Plans:

  • reduce the rate of visits to the emergency room and hospital
  • reduce the number of schools days missed due to asthma
  • reduces night waking due to asthma symptoms
  • improves symptoms

Develop or update the written Asthma Action Plan.

Annual flu vaccination

The best protection from the flu is annual flu vaccination. The flu virus is always changing, so it is important people with asthma are encouraged to have the flu vaccine every year. This will ensure they and their family are protected against the most recent flu virus strains that may be around.

It is best for patients to be vaccinated from mid-April so their body has time to protect itself before the flu season starts so they are ready for the peak flu period, from around June to September.

Everyone with asthma including all family members should be immunised against the flu. 

A 2016 Immunisation Coalition study showed that more than half the people who were vaccinated against the flu in 2016 made their decision based on the recommendation of their GP. This shows the potential of GPs and healthcare professionals to influence patients who may not otherwise choose vaccination, and help protect people with asthma.

Asthma resources and information

For more information and resources to help your patients get asthma ready this winter: