Asthma improvement measures

Proportion of patients aged 6 years or more with asthma who do not have spirometry recorded

Definition

  • Proportion of patients aged more than 6 years with asthma who do not have spirometry recorded.

Inclusion/exclusion criteria
  • Include all active* patients aged 6 years or more with a diagnosis of asthma.

Rationale

  • Perform spirometry as part of diagnosis for adults and children aged six years or more.1 Spirometry is the most appropriate lung function test for diagnosing asthma and for measuring lung function when assessing asthma control.1
  • Visit the National Asthma Handbook for more information on spirometry use in diagnosis and monitoring of asthma.
  • Spirometry with or without bronchodilator response is underperformed in primary care for the diagnosis of asthma.2

Calculation instructions

  • Instructions coming soon
  • Data audit tools extract and analyse practice-level data. Your PHN should be your point of contact for advice and training.

* The RACGP definition of an 'active' patient is a patient who has attended the practice three (3) or more times in the past two (2) years

 

Proportion of patients with asthma who are current smokers or have no smoking status recorded

Definition

  • Proportion of patients aged 15 years or more with asthma who are current smokers or have no smoking status recorded

Inclusion/exclusion criteria
  • Include all active* patients aged 15 years or more with asthma who are current smokers or for whom no smoking status is recorded

Rationale

  • Smoking is the behavioural risk factor responsible for the highest levels of preventable disease and premature death.5
  • Smoking further impairs lung function, increases symptoms and impairs the effectiveness of asthma treatments.5
  • First-line management of all smokers with asthma should always be strong encouragement to quit.5

Calculation instructions

  • Instructions coming soon
  • Data audit tools extract and analyse practice-level data. Your PHN should be your point of contact for advice and training.

* The RACGP definition of an 'active' patient is a patient who has attended the practice three (3) or more times in the past two (2) years

 

Proportion of patients with asthma who have not had a repeat prescription for a preventer issued in the previous 8 months

Definition

  • Proportion of patients with asthma (who have a history of preventer use) who have not been prescribed a preventer in the previous 8 months

Inclusion/exclusion criteria
  • Include all active* patients with asthma and a history of preventer use without a new prescription for a preventer in the last 8 months.
  • Preventers include inhaled corticosteroids +/- LABA (long-acting beta2 agonist), and/or oral montelukast.1
  • For current preventer options see the Australian Medicines Handbook.

Rationale

  • A maximum of 6 months’ supply is available for a single PBS prescription for asthma medicines. An 8-month gap has been suggested, as non-adherence is common.
  • More than 8 months since the last prescription may indicate treatment adherence needs review, or that the patient may have stopped preventer treatment altogether.

Calculation instruction

  • Instructions coming soon
  • Data audit tools extract and analyse practice-level data. Your PHN should be your point of contact for advice and training.

* The RACGP definition of an 'active' patient is a patient who has attended the practice three (3) or more times in the past two (2) years

 

References

  1. National Asthma Council Australia. Australian Asthma Handbook, Version 2.0. Melbourne: National Asthma Council Australia, 2019 (accessed 5 September 2019).
  2. Chung LP, Johnson P, Summers Q. Models of care for severe asthma: the role of primary care. Med J Aust 2018;209:S34-S40.
  3. Australian Institute of Health and Welfare. National asthma indicators – an interactive overview (web report) Cat no ACM 38. Canberra: AIHW, 2019 (accessed 11 December 2019).
  4. Chauhan BF, Chartrand C, Ni Chroinin M, et al. Addition of long‐acting beta2‐agonists to inhaled corticosteroids for chronic asthma in children. Cochrane Database Syst Rev 2015:CD007949.
  5. Royal Australian College of General Practitioners. Supporting smoking cessation: a guide for health professionals. Melbourne: RACGP, 2011 (accessed 10 December 2019).