Vol. 13 •Issue 5 • Page 8
Boosting Asthma Awareness
My hairdresser was 10 minutes late for my appointment, and she began a long apology. She had spent the night in a hospital emergency room receiving treatment for her asthma, which had flared up due to a respiratory infection.
I learned that she had asthma since she was a young girl. She remembered waking up before school with swollen lips and eyes because she had been struggling to breathe during her sleep. Now, her children had been diagnosed with asthma, too.
“Usually I just use my son’s inhaler when I start feeling bad,” she confided, “but it didn’t help much this time.”
I thought of the countless articles we’ve published about poor patient and physician adherence to the asthma management guidelines developed by the National Asthma Education and Prevention Program. Here was a case in point.
“I know a little bit about asthma,” I offered. “Doesn’t your doctor prescribe you inhaled corticosteroids as maintenance therapy?”
“All I know is that when I’m in trouble I take two puffs,” she replied. “That’s usually good enough for me. Steroids sound scary.”
Although the NAEPP guidelines recommend daily use of anti-inflammatory medications as a first-line asthma treatment, research has shown that patients with persistent asthma, like my hairdresser, often underuse them or don’t use them at all.
The consequences of undertreating asthma are staggering: Each year 12 million people have asthma attacks, 1.8 million people visit emergency departments for asthma-related problems, and 5,000 people die from asthma. Direct health care expenditures for asthma total more than $8.1 billion annually. These costs could be avoided if more patients understood the vital role that inhaled corticosteroids play in their treatment plan.
The first step to getting this message out is to educate their primary care physicians about the importance of following the NAEPP guidelines. Although these principles are the gold standard for asthma treatment, physicians apply them inconsistently, studies have shown.
The second step is for these physicians to improve communication with their patients to dissuade their fears about the medications’ side effects and emphasize preventive asthma management. They must take the time to explain the rationale behind daily long-term and quick-relief medications and how to take them correctly.
May 4 is World Asthma Day. This is an ideal time to hold a program for general practitioners in your area to educate them on the NAEPP guidelines and ways to implement them.