Asthma Management Handbook

Highlights of Version 1.1 update

Version 1.1 of the Australian Asthma Handbook, published April 2015, is a minor update to the full edition published as version 1.0 in March 2014.

Table. Australian Asthma Handbook Version 1.1 clinical amendments Opens in a new window Please view and print this figure separately: http://www.asthmahandbook.org.au/table/show/96

Table. Australian Asthma Handbook Version 1.1 minor amendments Opens in a new window Please view and print this figure separately: http://www.asthmahandbook.org.au/table/show/97

Summary of key clinical changes and clarifications

Inclusion of new combination medicine

Amendments to explain the role and use of fluticasone furoate/vilanterol combination (introduced in late 2014) which, unlike previously available ICS/LABA combinations, is not available in a low dose formulation

Emphasis on long-term use of low-dose ICS in adults

Amendments to explain the aim of continuing low-dose ICS treatment long term in adults with a confirmed asthma diagnosis and to provide explicit advice against cessation without a significant clinical reason

Clarification that low-dose ICS should not be continued indefinitely in children

Amendments to clarify that low-dose ICS should not be continued indefinitely in children and to distinguish between the use of ICS and that of other preventers in children

Clarification of risk factors for developing asthma

Amendments to clarify the status of risk factors for developing asthma that have been identified in population studies and to emphasise that these cannot be used as interventions as they have not been shown to prevent asthma

Modification of acute management protocols

Amendments to accommodate transfer protocols for higher-level care from a wider range of clinical settings, and to clarify management of acute asthma that is initially assessed as mild/moderate or severe but does not improve after initial bronchodilator treatment

Other minor clarifications 

Other minor clarifications include:

  • Various amendments to clarify the role of FEV1/FVC in diagnosis in adults and to correct under-emphasis on this parameter in the previous version
  • Recommendations regarding cromones in children amended to provide practical dosage information
  • Advice regarding healthy eating for asthma amended to clarify intake of which foods high in saturated fats should be minimised
  • Practical dosage information added for magnesium sulfate and IV salbutamol in severe and life-threatening acute asthma, including acknowledgement of the scarce evidence, lack of clinical consensus and limited roles for their use