Uncontrolled or partly controlled asthma is due to poor inhaler technique, say experts

Asthma experts say that contemporary inhaler therapy for asthma has the potential to control the disease, but in real-life practice, the control is often not achieved in most patients due poor inhaler technique.

As per the Asia-Pacific Asthma Insights Management Survey, asthma treatment patients in India are either uncontrolled or party controlled asthma and the key reason for this poor control is poor inhaler technique.

Addressing a press conference on Friday, prior to the World Asthma Day on May 1, Dr Nalin Joshi at the Institute of Respiratory Disease, Sawai Man Singh Medical College said: “Only 36% of asthma patients use the inhaler properly. In the remaining patients the disease is either uncontrolled or partly controlled due of improper use of inhaler.”

Most of the patients find pressurised metered dose inhalers (PMDIs) difficult to use correctly, he said.

“Poor hand-breath co-ordination is one of the most commonly reported errors with pMDIs. Dry powder inhalers (DPIs) are breath-actuated and hence overcome the problem of hand-breath coordination.”

A significant proportion of patients, however, fail to use the DPI correctly as well and one of the common errors made by patients with a DPI is the failure to inhale forcefully and deeply through the device, leading to insufficient drug delivery, Joshi said.

“Due to improper use of inhalers, the medicine does not reach the airways and remain in the mouth itself.”

Joshi further said that doctors treating asthma patients should give time to the patients, explaining how to use an inhaler, which generally most of the doctors do not do.

Dr BS Sharma, a professor at the JK Lone Hospital, SMS Medical College said many patients frequently underutilise their medications or use their inhalers incorrectly, which can be detrimental to maintaining disease control.

A study was conducted in 2008-19 on 3,321 school-going children between the age of 5 and 15 in Jaipur in which 7.59% were found suffering from asthma and it was published in the Journal of Indian Paediatrics on October16, 2012, Sharma said.

In another study conducted in 2012-13 on 5,002 school-going children aged 5-18 years in Jaipur, in which 18.63% were found to be suffering from asthma, he said.

The study was published in the Indian Journal of Allergy, Asthma and Immunology in January-June 2018.

Both the experts said asthma cannot be cured but controlled. More than 10% of the population in Rajasthan suffers from asthma, the duo said.

Dust, smoke and perfumes are common allergies and different individuals react differently the triggers, said Sharma.

Apart from the trigger, obesity among children can increase the chances of asthma so children should be encouraged for outdoor activities, he said.

Childhood should not be snatched away from children by asking them not to eat ice cream or drink cold water among others, but we must try to find out the reasons that cause asthma and stay away from the triggers, Sharma said.

Both the experts said asthma patients should take medicine as prescribed by the doctors and lead a normal life.