Asthma Hospital Admissions Coming Down As New Zealand Leads The World In Asthma Management

The MRINZ study, Patterns Of Asthma Medication Use And Hospital Discharges In New Zealand, published recently in the Journal of Allergy and Clinical Immunology: Global, has shown that New Zealand is leading the world in the uptake of a novel management approach recommended as optimal asthma treatment.

The study revealed a remarkable 108% rise in the usage of the combination 2-in-1 inhaler budesonide/formoterol between 2019 and 2022. This surge in budesonide/formoterol use coincided with a notable 17% decrease in hospital admissions for asthma during the same timeframe.

Over the past decade, pivotal clinical trials conducted by MRINZ have established the superiority of the 2-in-1 inhaler in preventing severe asthma attacks compared to traditional single reliever inhalers. These studies laid the groundwork for the 2019 Global Initiative for Asthma (GINA) guidelines' endorsement of the combination inhaler as the preferred reliever medication across asthma severity levels.

The New Zealand asthma guidelines, issued by the Asthma and Respiratory Foundation of New Zealand (ARFNZ) in June 2020, specifically recommended budesonide/formoterol anti-inflammatory reliever therapy as the preferred treatment for adolescents and adults in Aotearoa. This led to a spike in budesonide/formoterol use, representing a pivotal moment in asthma management in New Zealand.

Dr Bryan Betty, Chair of General Practice New Zealand, commends the swift integration of world-leading asthma guidelines into general practice, affirming the country's commitment to top-tier healthcare. "This proactive approach promises enhanced asthma management for our communities," notes Dr Betty. 

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“This study yet again confirms the high quality of care New Zealanders receive from their general practice teams, with the rapid adoption of world-leading asthma guidelines. It is gratifying to see that this suggested change in management has already led to a reduction in hospital admissions in New Zealand.”

Professor Richard Beasley, Director of the MRINZ and asthma programme lead, also highlights exemplary primary care in New Zealand, attributing the successful adoption of budesonide/formoterol treatment to the collaborative efforts of general practitioners, practice nurses, and organisations like the ARFNZ.

“This study's positive findings indicate that well-communicated guidelines have the power to transform asthma management, enhancing patient care. The clear shift in prescribing patterns highlights the commitment of GPs throughout New Zealand to deliver evidence-based treatments for patients with asthma," states Professor Beasley.

This MRINZ research is supported by Health Research Council of New Zealand (HRC) Independent Research Organisation funding. This funding specifically supports independent organisations which are recognised by the government for their unique and significant national and international capabilities.

HRC Chief Executive Professor Sunny Collings says the HRC is proud to have invested more than $7.7 million into the three randomised clinical trials that form the backbone of these impressive health outcomes, including MRINZ's almost-complete world-first trial looking at the use of this 2-in-1 inhaler regime in children.

“These three trials are the only large randomised clinical trials of these 2-in-1 inhaler regimens that have been carried out independent of the pharmaceutical industry. By using novel technology — particularly electronic medication monitoring — the research team was able to get a more detailed assessment of medication usage patterns and associated risks than ever before, adding significant weight to the findings,” says Professor Collings.

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