asthma · mar 2025 · 3 min read

New asthma guidelines: what's changing and why

As your GP, I'm always looking for ways to improve your health while also considering our environmental impact. I recently came across an important report from Asthma Australia and Deakin University that outlines new strategies to improve asthma care while reducing the environmental footprint of inhalers.

What is changing in Australian asthma care?

The big shift is away from leaning on the blue reliever inhaler on its own. For many adults and teens, the guidelines now recommend a combination inhaler containing a corticosteroid and formoterol as both a preventer and a reliever. This is called an AIR (anti-inflammatory reliever) approach, and it is safer and more effective than relying on a SABA (like Ventolin) alone.

Key points for patients

• Asthma control needs improvement: About half of Australians with asthma don't have optimal control. This means many people experience symptoms unnecessarily, which can affect their quality of life.
• Environmental concerns: Some inhalers (like pMDIs) contain hydrofluorocarbon gases that contribute to climate change. There are alternatives we can explore together.
• Rethinking reliever inhalers: Many people overuse blue 'reliever' inhalers (like Ventolin). This over-reliance can worsen asthma outcomes in the long term.
• The importance of preventers: Inhaled corticosteroids (ICS), found in preventer inhalers, are essential for controlling asthma and reducing inflammation in your airways. Preventers should be used regularly as prescribed, even when you feel well, to keep your asthma under control.
• SABA vs ICS: Overusing short-acting beta2-agonists (SABA) like salbutamol without addressing the underlying inflammation is not effective and can increase your risk of asthma flare-ups. The focus is shifting toward using ICS-based treatments instead of relying solely on SABA relievers.

What's changing?

• New guidelines: For many adults and teens, guidelines now recommend a combination inhaler containing a corticosteroid and formoterol as both a preventer and reliever. This is called an AIR (anti-inflammatory reliever) approach and is safer and more effective than relying on SABA (like Ventolin) alone.
• Inhaler types: We might discuss switching to dry powder inhalers (DPIs), which are often just as effective but have a lower environmental impact compared to pressurised metered-dose inhalers (pMDIs).
• Education: Expect more information on how to improve your asthma control while also reducing the environmental impact of your treatment.

Why this matters for you

Good asthma control means fewer symptoms, fewer flare-ups, and a better quality of life. At your next appointment, we may:

• Review your asthma management plan
• Discuss your current inhaler use and technique
• Consider if a combination ICS-formoterol inhaler might be better for you
• Talk about reducing reliance on Ventolin/Asmol by focusing on regular use of preventers like Symbicort

Remember, preventer inhalers containing inhaled corticosteroids are the cornerstone of good asthma management. If you're using your blue reliever inhaler more than twice a week, it's a sign we need to adjust your treatment plan.

Let's work together to keep your asthma under control while also contributing to a healthier planet. As always, I'm here to answer any questions you may have about your care.

Source: Asthma Roundtable Report (PDF)

Dr Ahmed Al-Obaidi · FRACGP

General information only, not personal medical advice. Talk to your own GP about what suits you.