It isn’t easy being wheezy

  5 February 2024  NWMPHN | Pictured: cohealth asthma nurse educator with patient and mother.   

Childhood asthma is one of the most common reasons that children visit doctors, miss days at school or are admitted to hospital. It is estimated that around one in 10 Australian children have asthma.

Community asthma programs provide free education and support for children with the condition. An asthma nurse educator works closely with families to help them manage their child’s health.  

In the North Western Melbourne Primary Health Network (NWMPHN) region, cohealth and DPV Health provide these programs, which are funded by the Victorian Department of Health. 

Libby Spiers, asthma nurse educator at cohealth’s Community Asthma Program (CAP), told us about the support and education she offered for Charlotte, aged 10. 

“Charlotte was referred to the CAP by her GP,” she said.  

“She was first diagnosed with asthma at 2 years old. Now at the age of 10 she is experiencing uncontrolled asthma.  

“At the time of her referral she was using salbutamol daily and experiencing nasal congestion and itchy, watery eyes which seemed to correlate with the change in weather in spring.  

“During her recent review with her GP, Charlotte was advised to commence Nasonex® Allergy nasal spray daily and take an antihistamine daily to assist with these symptoms.   

“I first saw Charlotte with her mum, Penny, who advised Charlotte was currently well but was requiring frequent, sometimes daily, salbutamol at school, 4 puffs via spacer. She had noticed during sport at school and at home she is sometimes breathless when active. She sometimes used salbutamol for this.  

“Penny also noticed that Charlotte quite frequently gets an itchy nose and eyes. She gets a night cough when unwell, snores most nights and had eczema when she was younger. She has had one other exacerbation of asthma, viral induced, this year and has required oral prednisolone twice in the last year during these exacerbations.”  

Based on this, Libby and the family identified 4 goals: 

  • Increase asthma self-management by identifying and minimising triggers. 
  • Keep an asthma diary of signs and symptoms and frequency of salbutamol use. 
  • Use the Melbourne Pollen app to track high pollen days to assist with monitoring symptoms and antihistamine use. 
  • Trial the use of Nasonex Allergy nasal spray for Charlotte’s hay fever symptoms. 

A management plan was implemented. It comprised: 

  • Liaison with Charlotte’s GP about commencing her on a preventer due to interval signs. 
  • Bloods checked for immunoglobulin E (IgE) levels due to the family pets, as well as pollens, grass and house dust mites.  
  • Allergen-impermeable covers for mattresses and pillows and purchasing a high efficiency particulate air (HEPA) air purifier for the bedroom to remove additional animal dander and dust.  
  • Trialling 2 puffs of salbutamol via spacer prior to exercise. 
  • Update and review Charlotte’s written asthma action plan (WAAP). 

“Since commencing the above recommendations, I liaised with the GP to discuss the recommended changes including ordering bloods, prescribing a preventer and reviewing and signing off on the new WAAP,” explained Libby.  

“After the initial contact with the family, I followed up with some phone reviews to check in on Charlotte’s progress. She was no longer needing salbutamol daily and her cough at night time had been minimal.  

“Penny has continued to track Charlotte’s symptoms using the asthma diary and feels that following the Melbourne Pollen app has greatly helped with reducing her hay fever. 

“By having the individualised support of an asthma nurse educator, Penny and Charlotte have been able to manage and minimise Charlotte’s ongoing asthma needs and triggers whilst also ensuring that she is able to partake in her everyday activities and most importantly be at school and do her gymnastics.  

“Charlotte hasn’t needed to have any more salbutamol at school and has not needed to present to the GP or hospital, like she usually would when unwell with her asthma, since being a part of CAP and starting her new regime.” 

More information  

Patients can self-refer to a children’s asthma program, or be referred by their GP. More information on services in our region can be found here:

  cohealth  DPV Health 
Eligible local government areas  Melton, Brimbank, Mooney Valley, Maribyrnong, Yarra, Banyule, Melbourne, Hobsons Bay, Wyndham.  Whittlesea, Hume, Darebin, Nillumbik, Merri-bek, Mitchell Shire, Macedon Ranges, Banyule, Loddon Mallee. 
Referral form for health professionals   Find out more on the cohealth website. Find out more on the DPV website.  
Contact details   Phone: 03 9448 6410 


Phone: 1300 234 263 (option 4)