Management and diagnosis of asthma is poor in India with only 40 per cent adherence, due to various myths surrounding the management of this disease. Keeping in view the World Asthma Day on May 6, city doctors came together on Monday to sensitise the masses on the early diagnosis of asthma and the right treatment to control the condition.
A study published in the lancet, a prestigious medical journal, for managing asthma states that half of all children have at least one episode of wheeze before 6 years of age, and 48 per cent of preschool children (younger than 5 years) with asthma report an asthma attack in the preceding year —a rate higher than any other age group. Emergency department visits and hospital admissions are also greater for this group compared with children and adults with asthma.
Dr Meenu Singh from PGI said, “Many people treat symptoms like recurrent coughing, early morning coughing, breathlessness, and wheezing themselves, with cough medicines or over-the-counter drugs. Also, there is immense fear associated with the word ‘asthma’ and ‘inhalers’ and it is this inhibition towards the disease and its correct treatment that is leading to the suffering.”
The most effective asthma treatment — Inhalation Therapy — is available in India at a price as low as `4 to `6 per day which means that a year’s supply of medicine is less than the cost of one night’s stay at the hospital. Even the lancet states that daily low-dose inhaled corticosteroids can prevent exacerbations in children with repeated wheezing episodes and effectively control asthma.
Due to lack of awareness, on asthma in India, prevents it from being diagnosed in the early stages and of the 30 million asthmatics in the country, most are unaware, undiagnosed or are being sub optimally treated for asthma. Further, it has been found that adherence to asthma medication regime is very poor and tends to falter after few months in both children and adults and the rate of non-adherence has been estimated to be around 70 per cent.
The scene of Asthma management in the Northern-region is also very poor. In PGI itself there are more than 10,000 registered patients who are asthmatic and around five to six new patients are being added daily to the list and in most of these cases the patient seeks consultation at a later stage.
According to experts it is important to diagnose asthma at an early stage as it helps preserve the condition of the lungs. Asthma usually manifests itself through symptoms like coughing, tightness in the chest, and wheezing but it is important to consider asthma as a diagnosis particularly if these symptoms are recurrent and consult a doctor at the earliest.
Dr SK Jindal, ex-PGI head of department said, “Asthma is a chronic disease which requires long-term treatment. Many patients once they feel better stops treatment after some weeks. This can be dangerous since stopping treatment can lead to reactivation of the disease and precipitate an asthma attack.”
There are many reasons why patients stop medication. These include unnecessary concerns about side effects, myths about inhaler devices, social stigmas and sometimes cost of medication. There are also several psychological barriers which lead to inhibitions such as dissatisfaction with healthcare professionals, inappropriate expectations, anger about one’s condition, underestimation of the severity of the condition and complacent attitude towards health.
Dr AK Mandal from Fortis Hospital said, “Initiation of inhalation therapy to an asthmatic child at the earliest helps in controlling the disease, prevents him from attacks, preserves the condition of his lungs and also improves the overall quality of his life. However the cases are being prolonged with oral tablets and injections due to lack of acceptance towards inhaled medicines.”
“It is the educated and affluent parents who are more difficult to be convinced on inhalation therapy. Firstly, they perceive asthma as a lifelong condition as they draw instances from their parents or grandparents suffering from the condition which is different from paediatric asthma. Also, this segment is internet savvy and may gather half-baked information from search results which also list incorrect details,” he added.