title: Near-fatal asthma in South Australia: descriptive features and medication use.
abstract: BACKGROUND
  Self-reported prior morbidity levels and medication use among survivors of a near-fatal asthma attack (NFA) were studied.
  
  
  OBJECTIVE
  To identify deficiencies in asthma management and opportunities for intervention.
  
  
  METHODS
  A hundred and twenty-seven consecutive patients aged 15 years or more presenting with a NFA to accident and emergency departments of teaching hospitals were interviewed.
  
  
  RESULTS
  High levels of morbidity due to asthma were reported. Most cases (79%) reported symptoms occurring at least weekly in the three months before their NFA. A mean of 20.8 days was reportedly lost from work, school or other usual daily activity in the 12 months before these events. Regular use of beta agonist as nebuliser solution was reported by 27% of cases, increasing to 34.5% in response to increased symptoms, while 41% reported use of nebulised beta agonist in response to the NFA event. Less than half of all cases (46%) reported using an inhaled corticosteroid on a regular basis. Oral corticosteroids were used by 33% of cases at times of increased symptoms in the preceding 12 months. However, only 7% of cases reported initiating or increasing oral corticosteroids at the time of the NFA.
  
  
  CONCLUSIONS
  Despite high levels of prior asthma morbidity, regular preventive inhaled corticosteroid use was not widespread in this series of NFA asthmatics. By comparison, over-reliance on regular beta agonist medication was common. Oral corticosteroids were rarely commenced in response to the NFA.
authors.affiliation: Department of Respiratory Medicine, Austin & Repatriation Medical Centre, Melbourne, Vic.
authors.forename: D A
authors.initials: DA
authors.lastname: Campbell
authors.forename: C G
authors.initials: CG
authors.lastname: Luke
authors.forename: G
authors.initials: G
authors.lastname: McLennan
authors.forename: J R
authors.initials: JR
authors.lastname: Coates
authors.forename: P A
authors.initials: PA
authors.lastname: Frith
authors.forename: P A
authors.initials: PA
authors.lastname: Gluyas
authors.forename: K M
authors.initials: KM
authors.lastname: Latimer
authors.forename: A J
authors.initials: AJ
authors.lastname: Martin
authors.forename: R E
authors.initials: RE
authors.lastname: Ruffin
authors.forename: P M
authors.initials: PM
authors.lastname: Yellowlees
authors.forename: D M
authors.initials: DM
authors.lastname: Roder
mesh_terms: D000280:Administration, Inhalation; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology*; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D009017:Morbidity; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013021:South Australia / Q000453:epidemiology
chemical_list: D000318:Adrenergic beta-Agonists; D018927:Anti-Asthmatic Agents