A year after a groundbreaking study found asthma patients were far better off using a two-in-one combined inhaler rather than separate devices, New Zealand's official advice has been updated.
One in six Kiwis has the condition, and most are prescribed two different inhalers - one delivering a daily dose corticosteroid to keep symptoms at bay, and a bronchodilator inhaler to relieve attacks. Research last year found most patients didn't use the preventative inhaler, just the bronchodilator as needed.
A follow-up study found combining the two inhalers into a single device reduced the chances of an attack by up to a third.
National guidelines have now shifted to recommend the two-in-one inhaler.
Prof Richard Beasley, director of the Medical Research Institute of New Zealand, told Newshub patients should have received a recall from their doctor by now.
"It's now the mandate of the New Zealand guidelines, and it's now something that health professionals in New Zealand should undertake as a priority."
He's disappointed it took so long for the official guidelines to be updated.
"It's been disappointing, I think, that it's taken us so long to get to this position. But now we have the evidence, we shouldn't delay it any longer."
The New Zealand guidelines were last updated in 2016 for adults and 2017 for children and adolescents.
"Since their publication, there have been a number of major advances in the treatment of asthma in adolescents and adults," the New Zealand Medical Journal reported on Friday, along with the full guidelines on how the condition should now be treated.
Prof Beasley says the difference between the two treatment methods is significant.
"Between one-third and two-thirds of a reduction in the risk of a severe exacerbation, which is why we've been able to make such a clear recommendation to make the switch."
The research
The study, conducted by Australian and Kiwi researchers last year, saw 890 adults split into two groups - half were given the new combined inhaler and told only to use it whenever they had symptoms, while the rest were told to keep using the preventer twice daily, and the reliever when they had symptoms.
The former group suffered 31 percent fewer attacks, despite inhaling about half as much of the corticosteroid substance which prevents attacks.
"This novel approach simplifies treatment as it doesn't require patients to take a preventer inhaler twice daily even when they have no symptoms," Prof Beasley said at the time.
"It also addresses two key problems in asthma management - the reluctance of doctors to prescribe regular preventer inhaler therapy and the reluctance of patients to use it when they feel well."
The research was published in The Lancet in August.
