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DR MIRIAM: HEALTH FOCUS: CONTROLLING ASTHMA: Now You Can Breathe Easier

Posted on: Thursday, 30 December 2004, 09:00 CST

ASTHMA is a chronic condition and more than five million people are treated for it in the UK.

UK children are more prone to asthma than any other children in the world.

This week Dr Miriam reports on the causes and treatments.

ASTHMA attacks account for almost 75,000 emergency hospital admissions each year and 1,500 deaths, most of which are thought to be preventable.

In the UK, treating asthma costs around pounds 2.5billion each year and results in the loss of 18 million working days.

At least 75 per cent of the total cost to the NHS is due to treating what happens when asthma gets out of control.

Symptoms

ASTHMA is caused by chronic inflammation of the airways - the tubes that carry air in and out of the lungs.

They become swollen and narrow, making it difficult to breathe, resulting in shortness of breath, tightness in the chest, wheezing and coughing.

Mild asthma attacks are common, with a feeling of tightness in the chest and the beginnings of a cough.

With severe asthma attacks, symptoms get worse quickly and breathing becomes difficult.

What starts attacks?

PEOPLE with asthma can be sensitive to a huge range of triggers that may induce an attack.

These include allergens (such as pollen, dust mites or pet dander), smoke and air pollution, exercise, cold air and stress.

Lack of control

PEOPLE with uncontrolled asthma tend to avoid situations that trigger attacks, such as taking part in sports or going to smoky bars.

It's estimated the vast majority of asthma patients' lives are curtailed by their condition. In fact, a recent report from Asthma UK found that over half a million people with mild to moderate asthma suffer a potentially fatal attack every day.

Here in the UK control of asthma symptoms is very poor. Only about five per cent of patients in the UK have well-controlled asthma.

GO FOR TOTAL CONTROL

THE aims of total control over asthma include:

No daily symptoms.

No rescue use of reliever inhaler (blue inhaler).

No night-time awakening.

No emergency visits.

No side-effects of treatment needing a change of therapy.

The Gaining Optimal Asthma Control study, involving 3,421 patients in 44 countries, discovered:

After a year of treatment nearly half the patients achieved total control.

Patients reaching total control could do so on 60 per cent less steroid than before.

The message, according to Professor Ashley Woodcock from Wythenshawe Hospital, Manchester, a UK investigator, is that: "You can be an asthmatic without actually suffering asthma." Good news!

Miriam Stoppard

TAKE YOUR MEDICINE

THE aim of asthma treatment should be complete freedom from symptoms, according to Global Initiative for Asthma (GINA) guidelines.

However, whether such control is achievable has never been researched until now.

Several medicines are used to treat asthma. Some of the most common are:

Short-acting broncho- dilators (blue inhaler)

THESE medicines, such as salbutamol, give immediate but short- lasting relief from asthma symptoms by opening up airways and allowing patients to breathe better.

Patients take them as needed, but needing them more than once or twice a week suggests asthma may not be as well controlled as it should be.

Long-acting bronchodilators (green inhaler)

THESE medicines, such as salmeterol, work in a similar way to short-acting bronchodilators but for a longer period. They dilate airways for up to 12 hours and can be taken along with an inhaled steroid.

Inhaled steroid (brown inhaler)

THESE medicines help treat the underlying cause of asthma - inflammation. They are taken on a daily basis and help prevent asthma symptoms and attacks.

Combination treatments

THESE medicines are a combination of an inhaled steroid to reduce inflammation and a long-acting bronchodilator to help airways stay open for a long time.

They're taken every day to prevent patients experiencing asthma symptoms and attacks.

The combination of salmeterol and the steroid fluticasone propionate was one of the drugs investigated in the international Gaining Optimal Asthma Control study.

The study investigated whether it was possible to gain total control of asthma symptoms. The findings are below.

Source: Daily Mirror

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