Preparing for thunderstorm asthma

To help pharmacists identify and advise at-risk patients on thunderstorm asthma, the National Asthma Council Australia (NAC) has released its updated resource – ‘Thunderstorm Asthma: prepare your patients for spring’.

Dr Jenny Gowan, pharmacist and member of the NAC Australia Guidelines Committee, says the new resource for pharmacists has been designed as a handy tool to identify and advise at-risk patients on thunderstorm asthma.

“A La Niña event now underway in the Pacific Ocean will increase the likelihood of above-average rainfall during spring and summer in eastern Australia, which can lead to above average grass growth and critically, ryegrass pollen.

“The peak spring and thunderstorm asthma season starts 1 October and lasts until the end of December and patients with hay fever and allergy to ryegrass pollen may be at risk of thunderstorm asthma – even if they have never had asthma symptoms before,” she said.

The flowchart for pharmacy provides evidence-based guidance on identifying and advising patients who are requesting medicines for asthma and allergic rhinitis and the steps to take depending on how the patient presents.

“If they present for allergic rhinitis, the steps include warning about probable ryegrass pollen allergy and the risk of thunderstorm asthma. It then goes on to cover advice about avoidance steps to take to reduce the risk of exposure to thunderstorms as well as asthma first aid during the grass pollen season.

“Importantly, it is also recommended that the pharmacist also asks whether the patient has ever had asthma, or a wheeze with their allergic rhinitis, and if so, that it should lead to a GP assessment or review of treatment.

“If they present requesting medicine for asthma, the steps cover warnings about the risk of thunderstorm asthma, advice about good asthma control, steps for the avoidance of risk and asthma first aid.

“The flowchart also recommends the pharmacist also asks if the patient has allergic rhinitis, worsening asthma symptoms during spring and also preventer use. If needed, the pharmacist can then provide the appropriate advice, or recommend a GP treatment review.

“We urge every pharmacy to inform all of their staff about the flowchart so they know to direct patients to the pharmacist to undertake the appropriate steps and then supply the appropriate medicines as required,” Dr Gowan said.

In 2016, those affected by the devastating epidemic of thunderstorm asthma included people with asthma or a past history of asthma, those with undiagnosed asthma and also people with seasonal hay fever who had not ever had asthma.

“General practices and pharmacies, particularly those across South Eastern Australia, should also ensure they have an Emergency Asthma Plan Policy for patients presenting with an asthma flare-up, all staff are trained in asthma first aid and there are good supplies of reliever medications and spacers on hand, particularly for emergency use,” Dr Gowan said.

Read more on the Thunderstorm Asthma page in the Australian Asthma Handbook here

The NAC independently developed this resource with support from the Victorian Government Department of Health.

Health professionals can order free hardcopies from the National Asthma Council Australia at nac@nationalasthma.org.au.