19 November 2020

Asthma still particularly deadly to women, national data shows

Asthma Clinical General Practice Respiratory

Almost twice as many women as men suffered an asthma-related death in 2019, according to the latest national data that reveals a persisting trend across the decade.

According to figures from the Australian Bureau of Statistics, 272 females and 149 males made up the 421 asthma-related deaths last year.

But asthma proved consistently more deadly to women than men from 2012 to 2019, with male fatalities ranging from 133 to 149 during that time, and female fatalities from 248 to 312.

National Asthma Council Australia spokesperson Dr Jonathan Burdon told The Medical Republic he was not aware of much research into why women were at higher risk of asthma-related deaths than men, but suspected many women struggled to find time to visit their healthcare professional.

“Women are oversubscribed in the death rate – it has always been a concern to us, and this is reflected in the figures we’ve got from 2019. And we don’t really know why,” said Dr Burdon, a Melbourne-based respiratory physician.

Dr Burdon noted there was an increase in asthma-related fatalities for women under 54 years of age.

“Women in that age group are usually in the prime of their life, working and running families, and I suspect they don’t find time to look after themselves as well as we might like,” Dr Burdon said.

However, most deaths (264 of the 421) in 2019 occurred in people aged 75 and over, which could be partly to do with comorbidities, Dr Burdon said.

“In the older age group, physical disabilities may be a problem – for example, if they have arthritis in their hands and struggle to use an inhaler, or other disabilities that mean they struggle to get across the room to their asthma medication.

“Forgetfulness in taking medication, concerns about interactions of asthma medications with other medications, and cost are other things clinicians need to consider here – as well as under-diagnosis.

“People with shortness of breath may regard it as ‘oh well, I’m 65’ but the answer is no, you don’t get short of breath at that age unless there’s some problem, so we need to consider the possibility of asthma.”

Although asthma-related deaths in Australia are down from the peak of 964 in 1989, Dr Burdon said he was worried the numbers had not dropped further.

“The 2019 death toll was up slightly, at 421 from 395 deaths in 2018, but if you look back at the death rate over the past eight to 10 years, it’s been up and down a bit around those numbers … whilst we’ve made progress over the last 30 years, we seem to have bottomed out around the 400 mark.

“One of the things to consider with the death rate is we know that something like 40% of people with asthma who are prescribed regular preventative medication don’t take it regularly.”

Dr Burdon said aside from reinforcing the importance of patients taking their preventative medication, he would encourage regular asthma reviews.

“You need to get a new script every six months so that’s a good reason for touching base with your doctor – but if your asthma is not getting better, seek help.

“Occupational-induced asthma is something else that GPs and respiratory physicians should also keep in mind when someone is presenting with shortness of breath, particularly if the symptoms are worse at work or following work.”

The Asthma Council has released an updated chart to guide health professionals on the latest types of asthma and COPD medications available in Australia, as well as an update of the monoclonal antibody therapy for severe asthma to include the addition of a new therapy.

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