Research

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Respiratory disease
Volume 224 - Issue 6

Worsening Asthma Outcomes in Australian Adults: A Comparison of Stratified Sample Surveys in 2012 and 2021

Authors:  Helen K. Reddel, Maria R. Ampon, Leanne M. Poulos, Sharon R. Davis, Brett G. Toelle, Guy B. Marks, Taehoon Lee

Correspondence: helen.reddel@woolcock.org.au

Med J Aust 2026 || doi: 10.5694/mja2.70221
Published online: 23 June 2026
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Abstract

Objectives

To report patterns of asthma control, medications and healthcare utilisation in Australian adults with asthma in 2021, and assess changes since a similar survey in 2012.

Study Type

Cross-sectional web-based survey (February–March 2021; n=5427), compared with a similar 2012 survey (n=2686).

Setting/Participants

Adults (≥18years) with asthma, recruited from large web-based panels, with enrolment stratified by age group, gender and state/territory.

Main Outcome Measures

Asthma control test (ACT), healthcare utilisation and medications.

Results

Median age was 46years; 59% of participants reported female gender. Compared with 2012, fewer participants had well-controlled symptoms (ACT≥20: 2021, 48.0%; 2012, 54.4%; p<0.001), and more had very poorly controlled symptoms (ACT 5–15: 2021, 26.8%; 2012, 22.9%; p<0.001). Urgent asthma healthcare had increased (2021, 37.9%; 2012, 28.6%; odds ratio 1.53 [95% confidence interval, 1.37–1.69]; p<0.001). Inhaled corticosteroid (ICS) use in the previous year was similar (2021, 60.9%; 2012, 60.8%) but adherence was lower (p<0.001). Fewer participants had good symptom control while taking little/no ICS (2021, 33.4%; 2012, 40.1%), and more had uncontrolled symptoms with little/no ICS (2021, 38.1%; 2012, 25.6%; p<0.001); among the latter group, urgent healthcare utilisation had increased (2021, 63.5%; 2012, 41.2%; p<0.001). In 2021, 28.7% reported using oral corticosteroids for asthma in the previous year; only 42.0% of ICS users recalled their inhaler technique having been checked in the past 12months. Overuse of short-acting beta2-agonists was common: 56.3% adults obtained ≥3 inhalers in the previous year, and 10.5% obtained ≥12 inhalers. For symptom relief in the previous 4weeks, only 13.3% adults reported using an anti-inflammatory reliever (ICS–formoterol).

Conclusion

Our comparison of these two large nationally stratified sample surveys demonstrates significant worsening of key asthma indicators between 2012 and 2021, including worse symptom control and urgent healthcare use, but also indicates opportunities for improvement. The findings highlight an urgent need for system-wide implementation of the 2025 Australian asthma guidelines to reduce preventable morbidity.

Trial Registration

ACTRN12620000977976p

View this article on Wiley Online Library

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