'Consistency is key': How to have good control over asthma
MANILA, Philippines — It does not mean that when you are not wheezing, breathless or experiencing tightness in your chest, your asthma has already gone away or you have it under control.
On the contrary, you have asthma under good control when you consistently follow your doctor's order by taking in your prescribed medications.
Good asthma management and control is achieved by consistently observing preventive healthcare, said Professor Dave Singh.
"People with asthma, they stop taking medicines when they shouldn't because somebody told them, 'Last week, you didn't have symptoms then you can stop your meds.' And there's no basis for this and this becomes a huge problem," Singh said at a recent virtual roundtable with Philippine press.
Singh was in the Philippines to attend related medical fora on asthma and lung diseases. He is a professor at the University of Manchester whose research interests include the pharmacotherapy of asthma and chronic obstructive pulmonary disease (COPD).
"Asthma is a condition (wherein) a patient (has) good weeks and bad weeks. If you have a good week, the key is to make sure that the next week is a good week as well and then the one after that. The way you do that is by carrying on with your medicine, living a healthy lifestyle, not by stopping your medicines. This is very simple," Singh stressed.
Asthma is a chronic respiratory disease that requires maintenance medication. An effective way to manage it is through a preventive daily treatment using inhaled corticosteroids (ICS) therapies, alongside other prescribed medication that a patient might have.
In the Philippines, the National and Health Nutrition Survey stated that the overall prevalence of asthma was estimated at 8.7% based on wheezing for the past 12 months. And according to the 2017 World Health Organization data, asthma deaths in the country reached over 13,000.
An additional study shows that nearly 50% of asthma patients in Asia have uncontrolled asthma, despite the same research stating that over 80% of patients consider their asthma to be controlled.
The professor was part of "New Versus Old: The Impact of Changing Patterns of Inhaled Corticosteroid Prescribing and Dosing Regimens in Asthma Management," a modeling study that looked at different published research.
Good asthma control
Singh said there are many different concerns that prevent good management of asthma. Apart from underdiagnosis of the condition and low-adherence or non-adherence to prescribed medications, the different ways of managing asthma is also a concern related to the disease because it also creates confusion for both doctors and patients.
Their study aimed to address this concern.
"We found that if patients with asthma were to take corticosteroid earlier, inhalers, inhaled corticosteroids, they reduce inflammation in the lungs. And if patients were to take them regularly, that would offer the best opportunity of achieving good asthma control," Singh said.
He described good asthma control as a situation wherein a patient exhibits less symptoms and less visits to hospitals.
Doctor Gyneth Bibera, Country Medical Director of GlaxoSmithKline Philippines Inc., shared a similar observation as Singh.
“When it comes to asthma, poor patient perception is a serious risk. The belief that patients usually have is that their condition is not as serious as it actually is. When in reality, they are already experiencing underlying complications, such as airway inflammation, airway remodeling, decreased lung function and bronchial hyperreactivity,” Dr. Bibera noted.
She added that this underestimation of asthma's severity often leads to complacency. This "heightens the risk of asthma attacks, emergency hospital visits, a decreased quality of life, or even death.”
Both Singh and Dr. Bibera stressed that asthma treatment should be preventive and dealt with consistency of treatment for the chronic condition.
