Guide to an effective management of asthma
#BEROKZINDAGI TO WINNERS AGAINST ASTHMA
- Call for an increased awareness and dialogue on asthma and adoption of the right treatment to improve patient outcomes
- Call comes in light of the concern that up to 7 out of 10 patients in a region with asthma do not use inhalation therapy
- Less than a quarter (15%) of people with asthma in a region lack having an action plan in place
- While pediatric asthma is on the rise, in the adult age group men clearly out-number women in having asthma.
Chennai 3rd May 2019 : With the aim to dispel myths and fears
regarding asthma and encourage those affected by this condition to live a life
without limits, with World Asthma Day, let’s eliminate the stigma around
inhalation therapy and make it more socially acceptable and help foster further
dialogue between patients and their physicians.
 |
|
Dr.
P K Thomas, Chest Physician, Fortis Hospital, Dr.D Vijayasekaran, Pediatrician
& Pulmonologists, Apollo Children’s Hospital
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Asthma
is a chronic (long term) disease usually characterized by airway inflammation
and narrowing of the airways, which can vary over time. It is estimated that in
at local doctors on a daily basis see an average of around 40 patients
suffering from asthma/respiratory diseases. Out of these a majority are men
(60%) with the pediatric asthma segment has seen a significant increase on a
year on year basis (doctors reckon they see an estimated 25-30 new cases of
children with asthma every month). On average until the date in 2018, there has
seen a 5% increase in the number of people suffering from asthma as compared to
last year. Meanwhile, the number of patients using inhalation therapy has
increased in the last few years, an estimated 20% of asthmatics discontinue
inhaler use largely during their pre-teen and teenage years
The
reasons for the prevalence of asthma can be attributed to air pollution to the
increase in air particulate matters, smoking, incorrect treatment in children,
seasonal variations causing viral infections such as common flu and largely
ignorance amongst parents.
Speaking
on the occasion of World Asthma Day, Dr.
P K Thomas, Chest Physician, Fortis Hospital said, “It is very significant to change the perception towards Asthma and
Inhalation Therapy. While inhalation treatment can play a crucial role in
reducing the impact of asthma on people’s lives, compliance is crucial. Inhaled
medicines help to deliver the drugs directly to the lungs. But we need patients
to adopt the treatment as they are prescribed in order to get the full benefit.
Inhalation therapy works to control asthma by preventing & relieving
symptoms and reducing flare-ups, but they will work if patients work in
partnership with their GP and take them in the way they are prescribed.”
It
is important to note that symptom-free is NOT asthma free.
This remains one of the biggest challenges to the management of asthma when
there is discontinuation of the medication once the symptoms have subsided.
This can be majorly to save the cost of the medication. Unfortunately, this may
result in the aggravation of the disease and chances are that symptoms may
flare up anytime - this time with double impact. It is important to understand
being symptom-free does not mean one is free of the disease. Always, consult a
doctor before taken such steps. Asthma requires long-term treatment. Many
patients once they feel better to stop taking their inhalers. This can be
dangerous since discontinuing treatment means stopping the very thing that is
keeping them fit and healthy. Patients should consult their doctor on each and
everything that stops them from not continuing inhalers rather than taking a
decision which can be dangerous.
According
to Dr.D Vijayasekaran, Pediatrician
& Pulmonologists, Apollo Children’s Hospital “Ongoing education is of paramount importance in chronic diseases like asthma.
This is precisely where #BerokZindagi will lead to “Winning against Asthma” and
will enable patients to participate and have a more effective role in their own
treatment, working together with doctors to achieve optimal inhaler use and
disease control, thereby living life to the fullest. While encouraging an
increased dialogue on the management of asthma, lets us mark World Asthma Day
to directly resonate with our endeavor of enabling people with the condition to
achieve more in their daily lives.”
There
are many reasons why patients stop inhalers. These include unnecessary concerns
about the cost of medication, side effects, myths about inhaler devices and
social stigmas. There are also several psychological barriers which lead to
inhibitions such as dissatisfaction with healthcare professionals,
inappropriate expectations, anger about one’s condition, underestimation of the
severity of the condition and casual attitude towards health. The need for an
hour is to overcome barriers/ taboos and understand the importance of
inhalation therapy and adhere to it. To be a winner against asthma, an
effective treatment i.e. inhalation therapy is required. The treatment is
available in India at a price as low as Rs.4 to Rs.6 per day which means that a
year’s supply of medicine is less than the cost of 1 night’s stay at the
hospital.
"Inhaled corticosteroid therapy (ICT) is the
cornerstone of asthma management. For the effectiveness and safety of any
treatment modality, optimal drug delivery is crucial. In the case of ICT, the
drug reaches the inflamed airways directly in small doses, limiting the
potential side effects. In the case of oral medication, the drug dosage is many
times higher than in ICT. This excess dosage then reaches other parts of the
body too, where it is not required and increases the systemic side-effects."
remarks Dr. Dr. P K Thomas, Chest
Physician, Fortis Hospital.
Myths associated with the treatment needs to be busted. Inhaled corticosteroids have been
recognized and widely accepted as the mainstay of asthma management. However,
due to lack of awareness, many people remain reluctant to take the therapy. For
many, the word ‘steroid’ conjures up the vision of building up muscles. Most
often corticosteroids are confused with anabolic steroids.
For
people suffering from asthma and COPD, corticosteroids can be lifesavers
because they help prevent or reverse the process of inflammation in the airways
while making them less sensitive to the triggers. Asthma patient adherence is a
major health and economic challenges. Several studies report poor adherence
towards asthma medication with measured rates of non-adherence ranging from 30
to 70 percent. Patients appreciate dose counters because they are convenient
and improve safety by allowing them to identify the number of doses of
medication left in their inhalers and to avoid running out of medicines when
required.
The
National Asthma Education and Prevention
Program (NAEPP), in its updated guidelines, recommended the use of inhaled
corticosteroid (ICS) therapy for mild, persistent asthma across all age groups,
including children1. Inhaled corticosteroids have been found to bring about
improvements in the quality of life of patients by helping reduce the frequency
of asthma attacks, improving asthma control, reducing the requirement of oral
steroids and by bringing down the frequency of ER visits and hospitalizations.
This
year on World Asthma Say, as we celebrate the spirit of those winners – who
have won their battle against asthma and taboos related to it. Awareness about
the disease, acceptance towards it and adherence to the right therapy, all this
can make one win against asthma. Today,
we learn from them how they made it possible through inhalation therapy – a key
to win against asthma, #BerokZindagi.
References:
1.
U.S. Department of Health and Human Services, National Institutes of Health,
National Heart, Lung, and Blood Institute Expert Panel Report 3:
Guidelines for the Diagnosis and Management of Asthma, Full Report
2007 National Asthma Education and Prevention Program. Available
at:www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf Accessed November 17,
2009.
2.
WHO fact sheet N°206
3.
L. COLICE, MD; HARTMUT DERENDORF, PHD; GAIL G. SHAPIRO, MD. Inhaled
Corticosteroids: Is There an Ideal Therapy. Medscape
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