Asthma

ADULT

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Acute exacerbation of asthma not responding to therapy
    • Asthma with any of the following features:
      • coexistent pneumothorax
      • pneumonia
      • silent chest
      • cardiovascular compromise
      • drowsiness
      • poor respiratory effort
      • SpO2 ≤<92%
      • Failure to respond to acute management
      • Respiratory distress
    • Refer to HealthPathways or local guidelines.
    • The aim of asthma management is to control the disease. Complete control is defined as:
      • absence of nocturnal symptoms
      • no symptoms on wakening
      • no need for reliever medications
      • no restriction in day-to-day activities
      • no days off school or work
      • no asthma flares (NAC)
    • Inhaler techniques and therapy usage should be assessed at each visit
    • A written, personalised self-management (action) plan should be provided to all patients

    Clinician resources

    Patient resources

Minimum Referral Criteria
Category 1
(appointment within 30 calendar days)
  • History of life-threatening asthma in the past 12 months requiring ventilation or ICU admission
  • Unstable asthma with consistent FEV1 < 60% predicted or z-score < -2.5
  • Asthma caused or exacerbated by workplace exposure where ability to work is affected
Category 2
(appointment within 90 calendar days)
  • Uncontrolled asthma despite optimal asthma treatment
  • Frequent asthma-related healthcare utilisation
    • asthma related hospital admission/s in the last 6 months
    • more than 4 primary care presentations with uncontrolled asthma in past 12 months
    • after-hours attendance (ED or after-hours GP) despite optimal treatment
  • Need for oral corticosteroids on more than 2 occasions in the last year
  • Asthma caused or exacerbated by workplace exposure where patient is still able to work as a result
  • Symptomatic asthma during pregnancy
Category 3
(appointment within 365 calendar days)
  • Uncertainty about diagnosis
  • Persistent reduced spirometry after at least 3- month of optimal treatment not explained by other pathology
  • Asthma education where this cannot be provided in the community

Please insert the below information and minimum referral criteria into referral

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention not otherwise accessible to the patient
  • For advice regarding management
  • To engage in an ongoing shared care approach between primary and secondary care
  • Reassurance for GP/second opinion
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)

2. Essential referral information Referral will be returned without this

  • Details of previous treatments and reasons for discontinuation
  • Smoking history

3. Additional referral information Useful for processing the referral

  • Allergy testing results
  • Vaccination Status
  • FBC results, Spirometry and FeNO result (exhaled nitric oxide), if available
  • CXR

4. Request

  • Patient's Demographic Details

    • Full name (including aliases)
    • Date of birth
    • Residential and postal address
    • Telephone contact number/s – home, mobile and alternative
    • Medicare number (where eligible)
    • Name of the parent or caregiver (if appropriate)
    • Preferred language and interpreter requirements
    • Identifies as Aboriginal and/or Torres Strait Islander

    Referring Practitioner Details

    • Full name
    • Full address
    • Contact details – telephone, fax, email
    • Provider number
    • Date of referral
    • Signature

    Relevant clinical information about the condition

    • Presenting symptoms (evolution and duration)
    • Physical findings
    • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
    • Body mass index (BMI)
    • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
    • Current medications and dosages
    • Drug allergies
    • Alcohol, tobacco and other drugs use

    Reason for request

    • To establish a diagnosis
    • For treatment or intervention
    • For advice and management
    • For specialist to take over management
    • Reassurance for GP/second opinion
    • For a specified test/investigation the GP can't order, or the patient can't afford or access
    • Reassurance for the patient/family
    • For other reason (e.g. rapidly accelerating disease progression)
    • Clinical judgement indicates a referral for specialist review is necessary

    Clinical modifiers

    • Impact on employment
    • Impact on education
    • Impact on home
    • Impact on activities of daily living
    • Impact on ability to care for others
    • Impact on personal frailty or safety
    • Identifies as Aboriginal and/or Torres Strait Islander

    Other relevant information

    • Willingness to have surgery (where surgery is a likely intervention)
    • Choice to be treated as a public or private patient
    • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service.  Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.

    • A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.

    • Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

Last updated: 3 December 2024

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