Sleepwalking towards more harm from asthma

Asthma continues to be a major but avoidable burden on the Australian health care system.1 It is a treatable and responsive disease, and much has been achieved in the years since asthma was declared a National Health Priority. However, we are locked into an old paradigm of care that does not serve the best interests of either patients or doctors and is long past its use-by date.2 Several key issues need urgent attention and action: fragmented and suboptimal care,3 over-reliance on reliever therapies,4 neglect of rural and remote populations,5 and overprescription of oral corticosteroids.6, 7 Add to this the impact of environmental threats such as climate change, wildfires,8 thunderstorm asthma, and respiratory viral pandemics,9 with the increasing association of asthma with obesity and sedentary lifestyle,10 and we have the ingredients of a perfect storm.