Why Asthma Still Kills

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.’) 

Improper use of medicines have increased asthma fatalities

Lack of Asthma Specialists; Statistics show that very few doctors and nurses know how to use asthma medications, also, doctors and nurses are  not doing enough to monitor their patients. Most Health Care Providers are not trained in proper care of asthma patients: As many as half the nurses who do these reviews aren't trained in asthma care, so they don’t always spot that someone is at risk.

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.

 Overuse of Reliever inhalers,

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.