Asthma is a common chronic inflammatory disease
of the airways characterized by variable and recurring symptoms, reversible airflow obstruction and bronchospasm. Symptoms include wheezing, coughing,
chest tightness and shortness of breath. It was estimated in 2011, that 235-300
million people globally have been diagnosed with asthma and it has caused
250,000 deaths.
‘If we just did the basics right, the lives of people with asthma would improve substantially and deaths from asthma would fall.’
The Royal College of Physicians, carried
out a review on the increasing trend of asthma fatalities and sadly highlighted
the following;
Complacency;
Unfortunately, the worst culprits are health
care providers in giving basic care needs of sufferers. They agree that this
have to be seriously tackled by government agencies. The review discovered that
sufferers with high risk of a fatal asthma attack; such as people with
uncontrolled asthma or who’d recently been hospitalized after an attack — were
often not recognized as needing urgent support.
Prescription
and Improper Use of Medicines;
In nearly half of the deaths, a key problem was
prescribing; for instance, not giving the right medication or dose, or checking
if patients use their inhalers correctly.
Kay Boycott says: ‘A third of patients make
serious mistakes when using inhalers, such as not breathing out first —as this action
empties the lungs to ensure they can breathe the medication in or not holding their breathing after taking
the medicine ('This means they aren’t getting the full dose.’)
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| Improper use of medicines have increased asthma fatalities |
RULES
FOR STAYING SAFE
See your GP IF:
· You are unsure if you’re using your inhalers
correctly.
· You use your reliever inhaler more than a few
times a day, or get through more than three inhalers a year.
· You’ve gone to A&E or been admitted to
hospital for your asthma.
· Asthma is waking you at night or interfering
with your daily life.
· You have not had an asthma review where your
medication, dosage, inhaler technique and triggers are reviewed by your GP or a
nurse trained in asthma — within the past year.
· You do not have a personal asthma action plan.
Reliever inhalers have fast-acting medicine to
relax airways. Patients shouldn’t need more than a few of these a year. The
national review found 39 per cent of those who died had more than 12 reliever
inhalers in a year; four per cent had more than 50. It stated that needing more
than 12 a year is a warning to doctors that a patient’s asthma is out of
control. Overuse of reliever inhalers may mean patients are not using their
preventer inhalers, which contain low doses of long-lasting steroids that
reduce inflammation.
Non
Use of Preventer Inhalers;
Dr Stephen Gaduzo, of the Primary Care Respiratory
Society UK, says that as relievers work quickly, it can seem that they are the
ones that work. But they are very short-term. ‘That’s why you need to use
preventer inhalers daily — whether you feel well or not,’ he says.
Lack
of Awareness is a Major Problem.
Dr Levy says: ‘Patients who have never had an
asthma attack or been in hospital for it think they aren't at risk, but anyone
with asthma can have an attack and any attack can be life-threatening, so it’s
crucial to make sure your asthma is well controlled with a preventer, even if
it’s mild.’
Have
Regular Follow Ups;
Another issue is that patients admitted to
hospital due to their asthma — which suggests their condition is uncontrolled —
do not always have follow-up reviews. This is where their medication, dosage,
inhaler technique and triggers are looked at by a doctor or asthma nurse. And
when people get an over-the-counter reliever inhaler in an emergency, they are
meant to notify their doctor and have a review.
Patients
should have an Action Plan, stating what to do when they have an attack, their
triggers, and the medication they are on and most especially, how to take their
inhalers.
Kay Boycott says: ‘This really improves survival
rates — 77 per cent of those who died didn't have a plan,’ just one in four
people with asthma have an action plan. It also advised parents to be vigilant
because children’s asthma is more changeable; thus the action plan must be
designed with the help of the doctor to fit the sufferer’s condition.
