Asthma Australia, the National Asthma Council and Lung Foundation Australia welcome the increase in funding for lung function testing handed down in the recent federal budget.
The use of objective lung function tests, known as spirometry, to diagnose asthma and Chronic Obstructive Pulmonary Disease (COPD) is imperative to ensure that people with these lung conditions are swiftly diagnosed and appropriately treated, and to avoid misdiagnosis.
Asthma affects 1 in 9 Australians and kills 400 people a year.1
Lung Foundation Australia estimates that approximately 1.45 million Australians have some form of COPD. COPD affects 1 in 7 Australians2 aged over 40 and is the second leading cause of avoidable hospital admissions3.
The rebate to general practitioners (GP) for conducting spirometry testing is currently $20.55 which doctors argue is low for the service offered.
The latest budget has promised to increase the rebate starting in November 2018, which will better reflect the time taken to conduct the test to confirm the diagnosis of asthma, COPD or other causes of airflow limitation. The rebate can only be claimed once per year per patient to make a diagnosis.
It is hoped the improved rebate will encourage greater use of spirometry testing in general practice to make an accurate diagnosis of asthma, COPD and other respiratory conditions.
Asthma Australia CEO, Michele Goldman said, “Asthma is a complex disease and spirometry testing is the gold standard; an objective tool to help doctors accurately diagnose asthma and COPD, as stated in the asthma management guidelines and COPD-X Guidelines.
“Respiratory symptoms could be caused by several conditions, so an asthma and COPD diagnosis should not be made based only on symptoms or response to treatment. This increased rebate supports GPs to follow the guidelines and use lung function tests to ensure they are providing the best care for people with asthma and other respiratory conditions.”
“The National Asthma Council welcomes the increased federal funding in spirometry,” said Ms Siobhan Brophy, Chief Executive Officer, National Asthma Council. “A lot of work has gone into ensuring adequate funding and support is in place for doctors to perform spirometry, which is critical to improve the timely diagnosis of asthma and COPD. The new rebate is a step toward the right direction.”
Lung Foundation Australia’s General Practitioner Advisory Group Chair, Dr Kerry Hancock, said the increased rebate is a step towards ensuring equitable access but it is important GPs are well supported to perform this important diagnostic function to minimise misdiagnosis in patients.
“An Australia study showed that 65% of people with COPD were only diagnosed on presenting to hospital with an exacerbation4. Well-performed spirometry is essential to avoiding delayed and misdiagnosis, and unnecessary cost to patients, achieving better symptom control, reducing the risk of exacerbation and maximizing quality of life,” Dr Hancock said.
“It is essential that training and quality assurance programs are in place to improve the skills and confidence of GPs to perform high quality spirometry testing to improve early and accurate diagnosis rates of COPD and asthma.”
Ms Goldman said: “Compared to other developed nations asthma rates in Australia are high and we still see 400 people lose their lives to asthma each year. We welcome this change and urge people with asthma to ensure they see their GP at least once a year for an asthma review and to get an up to date asthma action plan.”
“People who have not been diagnosed with asthma or COPD but have symptoms such as persistent coughing, wheezing and shortness of breath, should speak to their doctor. If a lung condition is suspected, patients can request lung function testing from their doctor.”
Canadian research released last year showed that misdiagnosis rates for asthma may be high.
The study5 showed that one third of the 600 participants may have been misdiagnosed with asthma and were able to gradually stop taking their medication under guidance from doctors.
The consequences of undiagnosed and poorly managed asthma and COPD can be very serious, including significant impacts on daily life, hospitalisation and life-threatening exacerbations.
Over diagnosis of these lung conditions could also result in side effects from treatment, unnecessary costs to patients and the healthcare system and missing another important diagnosis.
Anyone with questions about asthma can contact the 1800 ASTHMA Helpline (1800 278 462), or for queries on COPD contact Lung Foundation Australia via free-call 1800 654 301.
Annette Stenhouse – 0416 861 732
Michele Goldman is available for interview.
1 National Health Survey 2014-15, Australian Bureau of Statistics http://www.abs.gov.au/ausstats/abs@.nsf/mf/4364.0.55.001
2 Toelle B, Xuan W, Bird T, Abramson M, Atkinson D, Burton D, James A, Jenkins C, Johns D, Maguire G, Musk A, Walters E, Wood-Baker R, Hunter M, Graham B, Southwell P, Vollmer W, Buist A, Marks G. Respiratory symptoms and illness in older Australians: The Burden of Obstructive Lung Disease (BOLD) study. Med J Aust 2013;198:144-148
3Page A, Ambrose S, Glover J et al. Atlas of Avoidable Hospitalisations in Australia: ambulatory care-sensitive conditions. Adelaide PHIDU. University of Adelaide. 2007
4 Walters J AE, et al. Barriers to the use of spirometry in general practice. s.I. :Australian Family Physician, Vol 34,3: 2005.