Asthma

Political Parties respond to letter from ASI

Letter from Asthma Society to all political parties

Dear Representative,

Asthma is the most common chronic disease affecting all age groups from young children to adults. Between 24,000 and 26,000 people attend A&E every year in Ireland due to an exacerbation of their condition, creating an additional burden on an expensive and already overstretched resource. Ireland has the 4th highest rate of asthma in the world.

The Asthma Society represents the interests of the 470,000 people in Ireland who suffer from asthma. In partnership with a broad coalition of stakeholders in asthma care, including patients and their families, GPs and specialists, the Asthma Society is leading a drive to transform awareness, understanding and management of asthma in Ireland.

We now have excellent guidance on best asthma management practice worldwide, through the internationally agreed evidence based GINA Asthma Guidelines (1). Dr Pat Manning, Chair of the Society's Medical Committee, has been directly involved in this world class initiative. Through the implementation of the GINA Asthma Guidelines, the development of a national approach to asthma management will result in improved health for many, reduced hospital admissions, and reduced mortality

We are asking each political party to commit to working with us to achieve change and improvements in asthma care management in Ireland through a national approach.

Acknowledging the significant health, social and economic burden of asthma in Ireland we are seeking your commitment to work in partnership with the Asthma Society and support strategies to improve patient outcomes though a national approach, using these internationally accepted Global Initiative for Asthma (GINA) recommendations as a reference.

On May 17th we will be advising our members and the wider public of the responses that we have received from parties and placing the responses on our website.

Information about Asthma and the key elements of a strategy to improve asthma outcomes in Ireland is outlined below.

Yours Sincerely

Dr Jean Holohan
Chief Executive


The Facts about Asthma

  • Asthma affects up to 470,000 people in Ireland, making it is the most common chronic disease affecting all age groups from young children to adults
  • Between 24,000 and 26,000 people attend A&E every year in Ireland due to an exacerbation of their condition, creating an additional burden on an expensive and already overstretched resource
  • 6,000 patients are admitted to hospital annually due to severe exacerbations of their asthma (2,600 of these admissions are to paediatric units)
  • Tragically, in our vibrant and successful economy, asthma still results in more than one death every week.

The Trends
Between 1995 and 2003 the ISAAC Study(2) has reported a 42.1% relative increase in asthma diagnosis over that time period in the prevalence of children 'ever having asthma' in the Republic of Ireland.

15.2% in 1995 18.2% in 1998 21.6% in 2003

A public health response
Ireland has the fourth highest rate of asthma in the world and the increasing prevalence of the disease, with its associated medical, social and economic costs, raises important public health concerns. A strong national response to what is a rising epidemic is needed.

Between 35 and 50% of medical expenditures for asthma are a consequence of exacerbations, an asthma outcome most view as representing treatment failure. Hospitalisations, emergency department and unscheduled clinic visits, and use of rescue medication comprise the majority of exacerbation-related treatment costs.(3)

Is there a better way of spending limited healthcare funds to deliver improved asthma care?
It has been demonstrated in a variety of settings that patient care consistent with recommendations in evidence-based asthma guidelines leads to improved outcomes. Guidelines help set standards of clinical care, may serve as a basis for audit and payment, and act as a starting point for the education of health professionals and patients. (e.g. A model for an implementation program that has improved patient outcomes is provided by the national asthma program in Finland, a long-term, comprehensive, multifaceted public health initiative with well-defined targets for asthma guideline implementation(4,5)

Key Elements in a Strategy to improve asthma outcomes in Ireland

  • Dissemination and implementation of evidence-based guidelines at national and local levels
  • Identification and minimising of barriers to implementation
  • Guideline specific education for both healthcare professionals and patients
  • Establishment of a system to evaluate the effectiveness and quality of care:
    Accurate morbidity data
    Mortality Data (all asthma deaths accurately recorded)
    Audit of both process and outcome
  • Recognition of the economic and social value of interventions and guideline implementation
  • Setting of achievable goals for reduction of costly hospital admissions and A&E attendances by 2012

Reference

1 Global Strategy for Asthma Management and Prevention (revised 2006) www.ginasthma.org
2 Asher MI et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood. Lancet 2006; 368: 733-43
3 Weiss KB, Sullivan SD. The health economics of asthma impact and rhinitis. I. Assessing the economic impact. J. Allergy Clin Immunol 2001; 107 (1): 3-8
4 Haahtela T, Klaukka t, Koskela K, Erhola M, Laitinen LA. Asthma programme in Finland: a community problem needs community solutions. Thorax 2001; 56 (10): 806-14
5 Haahtela t, Tuomisto LE, Pietinalho A, Klaukka T, Erhola M, Kaila M, et al. A 10 year asthma programme in Finland:major change for the better. Thorax 2006; 61(8): 663-70

Parties Responses in alphabetical order:

Fianna Fáil - Click here to read response

Fine Gael - Click here to read response

Green Party - Please refer to Asthma and Allergies policy on the Green Party website.

Labour - Click here to read response

Progessive Democrats - Click here to read response

Sinn Fein - Click here to read response