Asthma: how to properly manage your treatment?
Asthma severely disrupts the quality of life of patients and is unfortunately the cause of about 63,000 hospitalizations and 2,000 deaths per year in France. The management of the person with asthma may still be largely optimized.
1. Chronic inflammation of the bronchi
This chronic inflammatory disease of the bronchi and reversible affects 5% of the population: 10-15% of young adults and adolescents, and 8-10% of children under school age.
When asthma is triggered, there is an airway obstruction, contraction of muscles and inflammation of the bronchi. The air then passing difficulty, chest tightness, wheezing, coughing and shortness of breath occur. The crisis ends often spontaneously within a few minutes to several hours, but can also be extended a few days is what is called an exacerbation.
Poorly controlled, the disease is a source of frequent and troublesome symptoms (three out of ten asthma are required to restrict their activities). It may also jeopardize the patient’s life: every year 63,000 patients are hospitalized with asthma, while 2000 deaths are directly attributable to this condition. But a care suited avoids the most severe events.
2. Manage and prevent asthma
The treatments are effective but require monitoring and regular adjustment. Overall, it distinguishes the crisis treatment and therapy. The first is a bronchodilator and short-acting system that can alleviate the immediate crisis. The second is based on inhaled corticosteroids to reduce crises and episodes of worsening.
However, 68% of patients are inadequately controlled or not (respectively 21% and 47%). That finding comes from the results of the European study Inspire (International Asthma Patient Insight Research) among 2,000 asthmatics. Moreover, nearly half of patients (47%) experienced a worsening requiring hospitalization or an urgent consultation in the past year.
3. Excessive use of bronchodilators
Lack of control is manifested mainly by a very important decision bronchodilators: 71% of patients surveyed use them daily or several times a day. Now we consider that using bronchodilator more than four times per week reveals a bad check …
Thus the number of periods of worsening is important, with 14 episodes on average uncontrolled asthmatics.
Yet the vast majority of patients recognize the signs of early deterioration of his asthma and its treatment spontaneously adapts by increasing doses of bronchodilators when they arise.
4. Negligence of DMARD
Finally, the problem comes from the therapy. The inhaled corticosteroids are used only later (at the peak of aggravation and not before) and at doses too low to achieve the desired anti-inflammatory effect and are necessary to prevent exacerbations.
In conclusion, patients should be better trained on how to adapt their treatment. Together, they should use a little less often to bronchodilators (no more than 4 times per week) and a little more to steroids. They should be used during the period of stress symptoms, which is six days between the beginning and peak of aggravation.
Tags: asthma