With millions of people in the UK living with asthma, find out the top tips to help manage the condition
In the UK, 5.4 million people are receiving treatment for asthma. That’s one in every 12 adults and one in 11 children. Asthma affects people of all ages and often starts in childhood. During childhood, it affects more boys than
girls, but in adults it is more common among women than men. Symptoms include wheezing, breathlessness, a tight chest and coughing. There is no cure, but there are effective treatments to keep asthma under control.
The mainstay of treatment
Asthma is mainly treated with inhalers. Most people need two types of inhaler and it is important to distinguish between these. Reliever inhalers (usually blue) control symptoms when they happen, while preventer inhalers (usually brown) are used daily to prevent symptoms from occurring.
Preventer inhalers contain corticosteroids to help control inflammation in the airways, which occurs when asthma triggers are encountered. Many people ask if steroid inhalers are safe, largely because there is a long list of possible side effects. Long-term steroid use has, for instance, been associated with reduced growth in children and osteoporosis in adults. However, medication is only prescribed if the benefits outweigh the risks. The dose of steroid in a preventer inhaler is very low and it is inhaled into the lungs with very little absorbed into the rest of the body. The risk of side effects is low.
It is worth remembering that a preventer inhaler reduces the risk of attacks and poor symptom control. Poorly managed asthma in children can itself compromise growth and can also result in the need for higher doses of steroids. Patients should be referred to the pharmacist if you have any concerns.
The right support
The pharmacy team is well placed to provide information and advice to people who suffer from asthma, including how to spot possible symptoms of the condition, coping with an asthma diagnosis, how to use prescribed medication and provision of lifestyle tips. Here are some points to consider:
- Encourage patients to use their asthma medication exactly as prescribed. This is the best way to prevent symptoms and reduce the risk of an asthma attack.
- Asthma can be unpredictable, so patients should always carry their reliever inhaler with them.
- Appropriate inhaler use is vital. Good inhaler technique is a must if the patient is to obtain an effective dose of their medication. If they are unsure about their inhaler technique, ask the pharmacist to show them how to use it and/or to check that they are using it appropriately.
- Patients should work with the pharmacist to get the most effective combination of prescribed medicines for their own particular symptoms. If their current medication does not seem to be as effective as it should, the pharmacist may be able to help. For example, if a patient has difficulty with one type of inhaler, they can explore other options with the pharmacist. If they are using a reliever and a preventer inhaler and still having symptoms, they may need to have a leukotriene receptor antagonist (LRTA) tablet prescribed as well as a preventer inhaler. Alternatively, a combination inhaler may be considered. There are lots of options. Patients shouldn’t suffer in silence.
- Encourage patients to work out what triggers their asthma so that they can avoid these if possible. Everyone has different things that can set off their asthma attacks. Triggers might be colds and viruses, chest infections, pets, pollen, house dust mites, smoking and second-hand smoke, pollution, female hormones, specific foods, recreational drugs and alcohol. The best way to help the body cope with asthma triggers is to take medicines as prescribed in order to reduce the sensitivity of the airways.
- A written asthma action plan is a core part of asthma management and all patients should have one as it can help to control symptoms and reduce the risk of asthma attacks. The plan should be drawn up with the help of a pharmacist, nurse or doctor and kept somewhere where it is easy for the patient as well as their family and friends to find (e.g. on a fridge door). It should be referred to regularly and taken to every healthcare appointment.
- It’s a good idea for patients to keep a photo of their asthma action plan on their phone or tablet and to send a copy to friends and family so that they will know what to do during an asthma attack.
- Patients should have regular (at least annual) reviews with the pharmacist, nurse or doctor. They should bring their asthma action plan, their inhalers and any other medication with them so that inhaler technique can be checked and any concerns they may have about their treatment can be addressed.
- Patients, family and friends should know what to do in the event of an acute asthma attack and be aware of when they need to seek medical help. They should have contact details for the GP (including an out-of-hours number), asthma nurse and pharmacist. Patients should be aware of how their symptoms change if their asthma gets worse. They should monitor their peak flow rate and keep a record of what is normal for them. They must also know how to use rescue steroid therapy if it has been prescribed for them.
- It is important to get a follow-up appointment as soon as possible after an asthma attack – preferably within two or three days. It may take time to get back to normal after an attack: the suffer may feel stressed or worried and find it difficult to get to sleep at night.