Unmasking Asthma Misconceptions – What is well-controlled asthma?
@TheKnowHow
Unmasking Asthma Misconceptions – What is well-controlled asthma?
Patients frequently assume they have their asthma under control when their reliever medicine is effective during an asthma episode. However, in this premise, they are fatally mistaken.
A well-controlled asthma is defined by the absence of bothersome breathing problems during the day and night, as well as the requirement for little or no reliever medicine (no more than two puffs of SABA per week). Patients may live a normal, productive, and active lifestyle. The absence of asthmatic episodes indicates that the underlying inflammation is under control, which is critical for maintaining optimal lung function.
On the contrary, daytime symptoms or the use of relievers more than twice a week, nighttime awakenings, or limitations in activity all indicate only partial control. If a patient has all the issues above, their asthma is deemed uncontrolled.
Although asthma care has improved over the years, the level of asthma control is not considered to be optimal in many nations. Over two thirds of asthma patients in the Middle East suffer from uncontrolled asthma. Why?
For decades, the standard therapy for mild asthma had been as-needed SABA for symptomatic relief. The rapid alleviation following inhalation is one reason behind patients’ over-reliance on SABAs. They believe, subjectively, that their asthma would be under control. Over-the-counter
purchase of SABAs and refilling of old prescription without consultation with physicians are further factors. In contrast to the high SABA use, the prescription of inhaled corticosteroids (ICS) or other controllers is underrepresented in the Middle East.
But because SABAs don’t have anti-inflammatory capabilities, this one-sided treatment has worse long-term effects. It increases the risk of asthma exacerbations, and death in comparison to the outcome when the right dosage of ICS and other Controllers are taken. Inadequate insurance coverage for asthma therapy with more expensive controllers and nonadherence to recommended medications—only 25% of patient population reported using their prescribed controllers regularly— adds to the problem. Poorly controlled asthma leads to more exacerbations and visits to the emergency department. According to regional studies, up to half of asthma patients in the UAE attend an emergency care facility at least once a year. Because of the severe situation, emergency doctors also one-sided rely on Reliefer medicine.
The present issue in the Middle East is that patients do not consistently see a pulmonologist, specialists educated of the current treatment guidelines. Yet, asthma is a lifelong condition, and having a specialized doctor by your side is invaluable.
To effectively treat asthma patients, professionals have developed schemes for children, adolescents, and adults that include several therapy stages, known as Asthma Stage Therapy. Treatment is gradually enhanced with the administration of additional different asthma medication or a higher dose. Individual patients’ therapy levels are regularly assessed and altered in accordance with the philosophy “Reduce, if possible, intensify, if necessary.” This requires, on the one hand, regular checks with the treating physician, but also that asthma patients monitor their own health status and document any complaints that occur.
Empowering and encouraging asthma patients to self-management is crucial to keep asthma under control.
Asthma self-management education aims to achieve seven essential objectives:
- Understanding asthma and breathing.
- Knowing asthma symptoms and keeping track of them.
- Improving communication skills with healthcare providers.
- Learning about asthma medicines and taking them correctly.
- Making changes in life to prevent asthma problems.
- Following good health habits like quitting smoking, managing stress, and exercising to stay active.
- Knowing what to do when symptoms aggravate.
