Who is at most risk of asthma death?

asthma reliever puffer on its side

Pharmacists are being urged to check patients’ inhaler technique, following the release of new data on asthma deaths

Women aged between 55 and 64 years of age who have asthma are being encouraged to take action to manage their condition, as new ABS data shows they are at risk of dying as a result of their condition.

In total, 441 asthma-related deaths were recorded in Australia in 2017, comprising 300 females and 141 males.

While the overall toll decreased by 14 from the previous year, the deaths of women aged 55 and 64 years doubled, from 16 to 32, says the National Asthma Council Australia.

Dr Jonathan Burdon, Chair of the National Asthma Council Australia and respiratory physician, said that while the overall drop in asthma deaths was welcome, the rising death figures for women in their fifties and sixties was most concerning.

“This is devastating for the families who have lost a loved one and highlights the urgent need for mid-life women to more proactively manage their condition,” he said.

“Women in this age group are often juggling a host of responsibilities from work to caring for children and ageing parents, and often put their own health last. It’s important that women prioritise time to effectively manage and actively monitor asthma symptoms, so their conditions do not get worse.”

Dr Burdon urged pharmacists to help by checking their patients’ inhaler techniques by asking them to demonstrate how they would use thier inhaler device and recommending that their patients watch the National Asthma Council’s inhaler technique videos.

There is not a definitive answer as to why mid-life women are more affected by asthma, but it is likely a culmination of factors, he said.

“Women have slightly higher prevalence rates for asthma, but we don’t have conclusive evidence as to why women are dying from asthma at more than twice the rate of men. This is happening globally, and studies suggest this is due to diagnostic, biological, lifestyle, societal or environmental circumstances.”

Asthma deaths in Australia have more than halved over the years, from a peak of 964 deaths in 1989 to 441 in 2017. In 2017 there were far fewer deaths amongst older Australians, with a significant drop in deaths amongst both men and women aged 75 years and over and women aged 65 to 74 years.

Dr Burdon said that ongoing education efforts played a role in reducing the toll, including the recent thunderstorm asthma prevention campaign in Victoria.

“The decrease in asthma deaths is due to the ongoing education of health care professionals, the community and patients on the latest scientific evidence in asthma management, including tools like the Australian Asthma Handbook, the national treatment guidelines for asthma.”

He encouraged pharmacists to contact their PHNs to attend an Asthma Best Practice workshop to earn CPD points, whilst upskilling themselves on the latest asthma management practices. The National

Asthma Council also has available a wide range of resources such as the handbook and special interest information papers.

Earlier this year Australia’s National Asthma Strategy was released. Aimed at reducing the impact of asthma on individuals, the community and the economy it supports effective self-management practices and targets high risk groups.

Dr Burdon said that asthma deaths are largely preventable and people with asthma and their carers need to ensure that they take appropriate steps to manage their asthma.

The National Asthma Council Australia advises patients to take the following action:

  • Don’t ignore or dismiss breathing problems
  • See your doctor for regular asthma check-ups
  • Follow an up-to-date asthma action plan
  • Ask your pharmacist to show you exactly how to use your inhaler correctly
  • Tell your doctor and pharmacist about other medicines you are taking
  • Get your flu shot in winter
  • Quit smoking and avoid other people’s tobacco smoke
  • Ensure those close to you know what asthma first aid steps to take.

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  1. Pharmacist Dehal

    S3 inhalers has become S4 (prescription only) in New Zealand because S3 reliever inhaler is being overused while patient does not seek preventive therapy resulting in blunt disease progression and mortality. In Australia it should also be reviewed.

  2. Bruce ANNABEL

    There’s a better option. Pharmacists should utilize more the opportunities provided to them by the S3 classification.

  3. Paige

    Ventolin abusers are some of the most arrogant patients in the pharmacy.

    ‘Ive been using this since I was 12 years old!!’ – All I asked is whether you would like to review your technique as you seem to use 20 sprays a day sir. No need to yell.

    • Jarrod McMaugh

      This response from a person with asthma is usually a confirmation that previous health professionals (probably over years) have been unsuccessful in engaging with this person and their health.

      There are techniques for breaking through this defensive response in a way that creates a positive interaction (and potentially, ongoing professional relationship).

      It’s easy to get discouraged (and even jaded), but the difference between a productive interaction and a “regular” interaction in this situation can be the difference between life and death. (and it can also be the difference between Pharmacist Only and Prescription Only availability, as demonstrated by recent changes in NZ)

  4. Debbie Rigby

    Inhaler device technique should be assessed at every opportunity, with prescription and OTC dispensing. Do more than “have you had this before?” Different opening lines (open-ended questions) could be “how is your asthma controlled?” “how’s your asthma with all this pollen around?” Start a conversation, not an interrogation!

    It can be effective to ‘normalise’ poor device technique: “up to 90% of people don’t use their inhaler properly. Can we run through how you use it today so you get the most out of your medicine?”

    It can also be effective to do an asthma control test – 5 easy questions (or just ask one or two conversationally) e.g. During the past 4 weeks, how often have you used your blue puffer or reliever medication. Using a reliever more than 2 days per week indicates partial or poor control.


    The Primary Care Asthma Control Screening tool (PACS) was validated in pharmacies and can also be used. ‘Yes’ to any question indicates that the person may have poorly controlled asthma, so more detailed assessment is needed with referral to their GP.


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