World Asthma Day 2022: Closing Gaps in Asthma Care

May 3 of this year is the 24th World Asthma Day with a theme to be "closing gaps in asthma care". The Global Initiative for Asthma, calls on the international respiratory communities to work together with colleagues, patients and health care providers to close the gaps in asthma care. 

The Global Burden of Disease Study 2015 estimated the number of people with asthma to be 358 million worldwide (a rough estimate is that one in 16 people in the world have asthma).

Wheezing is widely considered to be a typical symptom of asthma. But it is less known to all that chest tightness and coughing also could be symptoms of asthma, as Cough Variant Asthma and Chest Tightness Variant Asthma are subtypes of bronchial asthma.

The bronchial asthma is a chronic inflammatory airway disease with recurrent episodes of wheezing and shortness of breath with or without chest tightness or cough. It is often accompanied by airway hyperresponsiveness and variable airflow limitation.

Six Key Strategies to Manage Asthma

Although asthma is not curable, but the condition could be well controlled with good management. It is the joint efforts of physicians and patients that makes a difference in asthma management.

As an asthma patient, what should be done? Here are six key strategies.

1. Understand Asthma

Asthma is a controllable chronic airway disease that often attacks or intensifies at night or in the early morning. Its symptoms could be relieved by themselves or with treatment in most patients. With reasonable treatment and long-term management, asthma symptoms can be brought under control and acute attacks are preventable. However, non-standardized treatment or poor patient compliance can lead to repeated acute attacks, emergency room visits or hospitalization, and even death!

2. Identify Inducing Factors, and Avoid Them

The triggers for an asthma attack vary from people to people. Here are some common ones: hairy animals, cigarette smoke (second hand smoke), smoke, dust from bedding and pillows, dust in the air, strong odors, pollen, weather changes, colds, exercise and exertion etc.

Common inhalant allergens in life include dust mites, pollen, fungi, cat/dog hair, cockroaches. Common allergens in food include fish, shrimp, eggs, fruits, milk, nuts, etc. In China, dust mites are the most common allergens.

3. ICS as Bedrock, Rescue Medicine as Life Savior

There are controller medicine and relief medicine in terms of asthma medications.

Control therapy: Long term daily controller medicines should be regarded as important as three meals during the day, and can not be stopped or reduced randomly.

According to the Asthma Management Guidelines 2020, Inhaled corticosteroids (ICS) is the bedrock of medication treatment of asthma. Expert Panel no longer recommends short-acting beta2-agonist (SABA) as a single medication therapy without ICS.

Inhalation makes ICSs safer to administer with less adverse effects that often affects the oropharynx, causing hoarseness, pharyngeal discomfort and candida infection, so be sure to rinse your mouth carefully after use.

Relief Therapy: Also called rescue medicines, relief medicines are used as need in acute attacks. Asthma patients are recommended to carry this type of medicine wherever they go.

The first line quick-relief medicines are low dose ICS combined with Formoterol with SABA as the second option. Physicians shall evaluate whether patients can adhere to ICS controller therapy to reduce the risk of acute exacerbations associated with single dose of SABA.

4. Use Inhaler Correctly

Improper use of inhalers can lead to poor asthma control, so it is critical for asthma patients to use inhaler correctly.

When using the inhaler for the first time, patients are recommended to watch the instruction video first, then try to use the inhaler under physician’s guidance and practice it repeatedly. Patients should carry the inhalation device with themselves for every follow-up outpatient visit, so that the doctor can check the usage, and correct it in time if problem is identified.

When you find that the effect of the inhalation medicine is not so good, you should come to the hospital in time and ask the doctor to check.

5. Self-Monitoring Detect Early Signs of Acute Attack

Cough is the primary early sign of an acute asthma attack.

Asthma patients should not regard recurrent cough as merely an upper respiratory infection and are advised to visit the hospital promptly.

Peak expiratory flow rate (PEF) monitoring can be conducted easily at home. It is recommended that every asthma patient has a peak flow meter, just as a hypertensive patient always has a blood pressure monitor at home.

6. Make a Diary

 An asthma diary can include weather, diet, exercise and work, symptoms of the day, PEF measurement result, medication use, etc.

The diary is not only the key to self-management for asthma patients, and also helps patients to summarize and analyze asthma attacks and therapies together with the doctor, so that treatment plans can be adjusted timely.

There are many other ways to help asthma patients self-manage their conditions, such as phone-connected smart devises for lung function measurement or medication monitoring. We expect that asthma management will become easier and more intelligent with the introduction of wearable devices that can monitor acute asthma attacks in real time in the future.

Reference: https://ginasthma.org/closing-gaps-in-asthma-care-world-asthma-day-2022/