Inhalation therapy, a key to win big against asthma

New Delhi: When we think of Asthma, we picture a sneezing or a wheezing individual who seems to be perpetually ill. But is this the case every time? Often we try to run away from the harsh reality of the disease and ignore it, making the situation worst.

If diagnosed with Asthma, it is not the end of world as projected most of the time. Surprisingly, it can be managed and controlled easily. Daily activities with family and friends are not a tedious task or challenging with proper treatment. In true sense, one can win against asthma.

This year on World Asthma Day, we celebrate the spirit of those, 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.

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 done majorly to save the cost of the medication. Unfortunately, this may result into 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 taking such steps.

Dr. Randeep Guleria, Head of Department, Pulmonology & Sleep Disorder at AIIMS says, "Asthma is a chronic disease which requires long-term treatment. Many patients once they feel better 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 decision which can be dangerous."

Commenting on the current scenario of asthma, Dr. M K Sen, Senior Chest Physician at Safdurjung states, "Every day I consult 10 -15 patients that requires consultation not only for disease but for continuing the medicine. It has been found that adherence to asthma medication regime is very poor and tends to falter after few months in both children and adults and the rate of non-adherence has been estimated to be around 70 percent".

Dr. M K Sen says, "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."

Need of 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 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. Randeep Guleria.

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 is confused with anabolic steroids.

To clear apprehension on steroids, Dr. Randeep recommends, "It is important to understand that corticosteroids are not the same as anabolic steroids, which are taken by some athletes to illegally build the muscle mass. Corticosteroids are used in asthma treatment and they do not build muscles or enhance performance. They are hormones that are naturally produced by your body. And when a doctor prescribes you inhaled corticosteroids, he is giving you the same hormone in small quantities to ease your inflamed airways."

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.

Dose counters improves adherence to the therapy. Asthma patient adherence is a major health and economic challenge. 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."