Asthma Management and Telehealth in Australia

Asthma affects approximately 2.8 million Australians, making it one of the most common chronic conditions in the country. For people with stable, established asthma, some routine medication review can happen remotely. But asthma is not just an inhaler supply problem. Reliever use, night symptoms, activity limitation, recent attacks, and action-plan confidence all show whether the current plan is safe.

This guide covers what telehealth can and cannot do for asthma management, what requires in-person care, and when asthma symptoms should bypass telehealth entirely.

Understanding the boundary matters. Telehealth is appropriate for some asthma care and not others.

May be appropriate for telehealth:

• Medication review for stable, previously diagnosed asthma
• Discussion of reliever use, preventer adherence, triggers, and action-plan confidence
• Repeat prescribing where the existing plan remains appropriate
• Referral letters for specialist review when needed

Requires in-person assessment:

• First-time asthma diagnosis (spirometry required)
• Significantly worsening asthma control
• Stepping up treatment to a higher tier (e.g., adding a LABA or LAMA)
• Oral corticosteroid prescribing for acute exacerbation
• Any features suggesting anaphylaxis, vocal cord dysfunction, or another diagnosis
• Children under 12 with asthma symptoms

The key principle: if your asthma is stable and your current treatment is working, telehealth may be suitable for routine review. If things have changed, worse control, more frequent reliever use, new symptoms, or recent attacks, an in-person review is the safer choice.

Reliever Inhalers (Short-Acting Beta-Agonists)

Reliever inhalers are used for immediate symptom relief. They work by relaxing the muscles around the airways, opening them quickly during an episode of wheeze, chest tightness, or breathlessness.

Salbutamol (Ventolin, Asmol, Salamol): The most commonly prescribed reliever in Australia. PBS-listed. Can be prescribed via telehealth for established asthma patients.

Terbutaline (Bricanyl): An alternative SABA, also PBS-listed and prescribable via telehealth.

If you are using your reliever inhaler more than twice per week (outside of exercise), your asthma may not be optimally controlled. This warrants review and may need in-person assessment if treatment needs to change.

Preventer Inhalers (Inhaled Corticosteroids and Combinations)

Preventer inhalers reduce airway inflammation over time and are taken daily, regardless of symptoms. They are the cornerstone of moderate to severe asthma management under the National Asthma Council Australia guidelines.

Inhaled corticosteroids (ICS):

• Fluticasone propionate (Flixotide)
• Budesonide (Pulmicort)
• Beclometasone (Qvar)
• Ciclesonide (Alvesco)

ICS/LABA combinations (preventer + long-acting reliever):

• Fluticasone/salmeterol (Seretide)
• Budesonide/formoterol (Symbicort, Breyna)
• Fluticasone/vilanterol (Breo Ellipta)
• Fluticasone/formoterol (Flutiform)

Many preventer inhalers are PBS-listed for established asthma. For patients already stable on one of these medications, telehealth review may be clinically appropriate if no red flags or control concerns are present.

Maintenance and Reliever Therapy (MART)

The MART approach uses a single ICS/LABA combination inhaler (specifically budesonide/formoterol formulations) as both the daily preventer and the as-needed reliever. This is a recommended strategy in current Australian asthma guidelines for eligible patients. Telehealth is appropriate for prescribing MART continuation in patients already established on this regimen.

A telehealth doctor prescribing asthma medication will assess:

Asthma control: How often you are using your reliever, whether symptoms are waking you at night, whether asthma is limiting your daily activities. Poorly controlled asthma generally requires an in-person medication review rather than a simple repeat script.

Current treatment and adherence: Which medications you are currently prescribed, whether you are taking them as directed, and whether your inhaler technique has been checked recently.

Recent changes: Any new symptoms, recent respiratory illnesses, changes in exercise tolerance, or new triggering factors.

Prescription history: How long you have been on the current regimen and whether the most recent prescription was from a treating GP who has your full clinical history.

Red flags: Any features suggesting the diagnosis is not straightforward asthma, or that something more significant is happening (e.g., significant unintentional weight loss, haemoptysis, cardiac symptoms).

If the assessment is straightforward, routine prescribing may be appropriate. If anything suggests a medication change is needed or that asthma control is deteriorating, the doctor should recommend an in-person review rather than simply continue the existing plan.

The National Asthma Council describes poor current asthma control as symptoms or reliever use on more than 2 days per week, night symptoms or waking, or activity limitation during the previous 4 weeks.

Practical review questions include:

Telehealth boundary

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Repeat medicine review can be remote for some established patients; diagnosis, deterioration, and children need in-person care.

• How many days per week do you have daytime symptoms?
• Are you waking at night or coughing on waking?
• How often are you using a reliever, excluding planned use before exercise?
• Are symptoms limiting exercise, work, study, or sleep?
• Have you had an asthma attack, urgent visit, hospital care, or oral steroids recently?
• Do you have an up-to-date action plan?
• Has your inhaler technique been checked recently?
• Are you taking preventer treatment as directed?

If several answers suggest poor control, the issue is not just access to another inhaler. The plan may need review, triggers may need attention, inhaler technique may be wrong, or another diagnosis may need to be considered.

Many commonly prescribed asthma medications are PBS-listed in Australia when prescribed for eligible indications.

From 1 January 2026, before the PBS Safety Net:

• General patients pay up to $25 for most PBS medicines.
• Concession card holders pay up to $7.70.
• The 2026 PBS Safety Net thresholds are $1,748.20 for general patients and $277.20 for concession card holders.
• After reaching the threshold, general patients generally pay the concessional rate and concession card holders may receive eligible PBS medicines at no charge.

These figures apply to PBS-listed medicines and eligible patients. Private prescriptions, non-PBS medicines, brand premiums, delivery, and pharmacy-specific charges can change the final amount.

A written Asthma Action Plan tells you what to do when your asthma worsens - which medications to take, at what dose, and when to seek emergency care. The National Asthma Council recommends all people with asthma have an up-to-date written plan.

Your Asthma Action Plan should be reviewed whenever your treatment changes and at least annually. While a telehealth doctor can discuss your current plan and note any issues, a comprehensive plan review is best done with your regular GP who has your full history and can perform peak flow assessment in person.

Asthma can be life-threatening. Go to emergency immediately if:

• Your reliever inhaler is not improving symptoms after 4 puffs and 4 minutes
• You cannot complete a full sentence due to breathlessness
• Your lips, fingertips, or tongue are turning blue (cyanosis)
• You are working very hard to breathe (ribs visible during breathing)
• Your peak flow is below 50% of your personal best
• You feel unusually anxious, confused, or exhausted from breathing

Emergency signs

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Reliever not helping, trouble speaking, blue lips, exhaustion, or rapidly worsening breathing needs emergency care.

None of these presentations are appropriate for telehealth. Call 000 or get to the nearest emergency department.

Telehealth can work well for stable, established asthma where the treatment plan is unchanged and the review confirms control is good. It does not replace the respiratory assessment, spirometry, inhaler-technique check, or in-depth management review that in-person care provides.

If your asthma symptoms have changed, your control is worsening, you are using reliever medicine more often, or you have never been formally diagnosed, see your GP or a respiratory specialist in person.

• AIHW: Asthma in Australia
• National Asthma Council Australia: How is asthma managed?
• Australian Asthma Handbook: Assessing and reviewing asthma in adults and adolescents
• National Asthma Council Australia: Asthma first aid
• Better Health Channel: Asthma emergency first aid
• Services Australia: PBS Safety Net thresholds
• PBS: About the PBS