2nd May, 2011 | Mumbai
Asthma not under control in 62% of patients; majority do not adhere to regular treatment
On the occasion of World Asthma Day, city doctors highlighted that adhering to prescribed treatment is the most important aspect in managing a chronic disease like asthma. The scenario in India, as per a study done by Chest Research Foundation (CRF), however, indicates that compliance to asthma medication regime is very poor and an estimated 62% of asthma patients under treatment for at least a year do not have their asthma under control.
Highlighting the reason of non-adherence to asthma medications, Dr. Sujeet K Rajan, Consultant Chest Physician, Bombay Hospital said, “Adherence to treatment usually falters after a few months in both adults and children, once a patient benefits from the medicines and finds initial temporary relief. Very few asthmatics understand that asthma is an episodic condition where there would be days when the patient suffers from symptoms and this is generally followed by ‘asymptomatic periods’ during which the patient might feel that he does not require medication. This is one of the primary time-periods in patient treatment when he discontinues treatment assuming that he may not require any more medication.”
Commenting on poor asthma control among patients, Dr Prashant Chajjad, Lung care and sleep centre, Fortis Hiranandani Hospital, Vashi & Consultant Chest Physician, Nanavati Hospital observed, “Asthma patients who do not take their medication regularly could be at a higher risk of getting an asthma attack as their asthma is not under control. Uncontrolled asthma not only causes irreversible damage to the lungs but could even lead to hospitalization, loss of work and even death. The most effective asthma treatment is inhalation therapy which comprises of ‘Controllers’ for regular use as prescribed and ‘Relievers’ for emergency treatment. However, unfortunately patients in India have a psychological barrier to inhalers and feel that inhalers are the last resource and could be addictive. They need to be educated about inhalers being the safest, most effective and highly affordable for managing their asthma.”
Dr. Sundeep Salvi, Director, Chest Research Foundation said, “Going by what we know about the disease today and the effectiveness and affordability of inhaled drugs, asthma should be in control in at least 90% of patients. Yet, as the CRF study reveals, only 38% of asthma patients have their asthma under control. Fear of inhalers and complacency towards lung health could be the two major factors for such a drastic gap. ”
Reasons for poor asthma control
Once a patient benefits from the medicines and finds initial temporary relief, he tends to discontinue regular use of inhalers, as suggested by the doctor. It is only when the symptoms aggravate or he gets an attack that he takes resort to inhalers.
Many people wrongly believe that inhalers deliver ‘strong medication’ and that it should be used only when the disease is severely advanced.
More than 70% of asthma patients do not use their inhalers correctly and the resultant poor control is blamed on the medicine. Patients have been known to forget correct technique even after using the inhaler for several years.
Additional factors include overestimating control, stigma associated with inhalers, and ignorance about the need to control inflammation of the lungs.
While lack of compliance to prescribed medicines is a major reason, the study indicates that when it comes to asthma, control may depend on factors beyond medicines. The results show that in those patients who live in houses with damp walls, the risk of uncontrolled asthma is 3.15times higher. Also, the use of biomass fuels like wood, cow dung cakes and kerosene increased the risk 2.57 times.
Notes to the Editor: The study was conducted by Chest Research Foundation in 2008.
About Chest Research Foundation:
About Chest Research Foundation: Established in 2002, Chest Research Foundation (CRF) is an autonomous institution dedicated to research and education in the field of respiratory diseases. CRF is actively involved in creating new knowledge through research in Asthma and COPD (academic, clinical and molecular research) and empowering medical practitioners with this new knowledge through various educational programmes.
CRF has participated in several international research studies like the ISAAC (International Study of Asthma and Allergic Diseases amongst School Children) and recently in collaboration with Imperial College London, it is conducting a path breaking study in the field of COPD in rural India to establish that non-smoking COPD is a separate entity. Its research work has received accolades from national and international bodies in the form of several awards and orations and has several publications in national and international medical journals including The Lancet and Chest.
CRF also regularly conducts training programmes for doctors, which include detailed training in Spirometry, Pulmonary Function Testing, Asthma, COPD and a dedicated programme for Pediatric Asthma called CASPER. In order to increase its outreach, it has now developed an extremely simple interactive e-learning module for Spirometry called Spirometry Simplified which is now available on www.crf-learning.org .
Chest Research Foundation is also constantly striving to increase awareness amongst the masses about Asthma and COPD by way of free Spirometry Camps and Patient Education Programmes. For details visit www.crfindia.com.
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