On 16 September 2025, the National Asthma Council Australia released major evidence-based updates to the Australian Asthma Handbook with a significant change in asthma management for adolescents and adults. This shift is especially important for Aboriginal Community Controlled Health Organisations (ACCHOs), as it’s likely to affect many people in communities who have been relying on blue puffers for symptom relief.
Key Change in Asthma Management: no more short-acting beta agonists (SABA) only treatment
- Short-acting beta₂ agonists (SABA), like salbutamol also commonly known as “blue puffers”, are no longer recommended as standalone treatment for adults and adolescents. This is because even mild asthma can lead to severe flare-ups and death if not treated with anti-inflammatory medication.
- Initial treatment for mild infrequent asthma should now be treated with low-dose budesonide-formoterol (anti-inflammatory reliever (AIR)- only therapy) taken as needed.
- This combination provides fast relief and reduces inflammation—unlike SABA, which only treats symptoms.
Implications for ACCHOs
This change will have major implications for ACCHOs, particularly because many community members may be using blue puffers regularly—often without a formal asthma diagnosis or ongoing clinical review.
Key considerations include:
- Many patients will need reassessment: Those currently using SABA-only treatment may need to be reviewed and transitioned to the new recommended therapy.
- Community education is essential: People may not realise that asthma is a chronic condition that needs ongoing management—not just a quick fix when symptoms flare up.
- Pharmacy referrals may increase: Pharmacists are being encouraged to refer patients back to their GP or ACCHO clinic if they request a blue puffer without a current asthma plan.
- Asthma Action Plans are critical: Every patient starting the new therapy should receive a written plan to help them manage their condition safely.
For further information, review the revised 2025 Australian Asthma Handbook and a webinar on the new guidelines.
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