According to a recent survey by Asthma UK¹, nearly 47% of people living with asthma may not be receiving the proper treatment or are not being well advised on how to use their treatment correctly.

The research raises concerns about the significant number of patients who had received the wrong types of inhalers and the fact that some health professionals were not even identifying warning signs that could cause asthma to develop into a potential dangerous condition. Even though asthma is a relatively common condition and people think it doesn’t represent an immediate danger, Asthma UK warns that this is not always the case and many lives are actually at risk.
 
We believe that many of these situations can be prevented if patients learn how to better manage their condition. Small details make a big difference when it comes to treatment, therefore all patients should focus on certain elements when receiving their medicines. For example, every asthma sufferer should know that a long-acting reliever inhaler should never be prescribed without a preventer inhaler. In addition to this, asthma sufferers should also know that using 12 or more short-acting relievers in a year is a sign that their condition is not being kept under control. If this is the case, they should visit their GP.
 
We want to make sure that all of our patients who are struggling with asthma have all the information they need when following a treatment. To do this, below we take a look at the different types of inhalers and how they should be used. Inhalers come in a variety of shapes and sizes, but it is the colour of a device that usually shows the effect of the medicine:
 

1. Reliever inhalers

Reliever inhalers deliver the medication straight into the lungs and ease asthma symptoms by helping the muscles around the airways relax.
There are two categories of reliever inhalers: short-acting relievers, which include salbutamol and terbutaline, and long-acting relievers which include salmeterol, formoterol and tiotropium bromide.
 
Short-acting reliever inhalers are quick-acting medications designed for use in emergencies and in mild cases of occasional asthma. These inhalers help ease asthma symptoms quickly, as they are designed to quickly open the airways.
 
Short-acting relievers can only treat sudden asthma symptoms because while their action starts minutes after inhalation, it only lasts for two to four hours.  If you are using an inhaler of this type more than three times a week, or more than 12 of these inhalers in one year, you should visit your GP. Excessive use of these inhalers signals that your asthma is not being treated properly and this is something that could lead to a life-threatening attack.
 
Long-acting reliever inhalers are sometimes necessary to control asthma and should be used regularly, twice a day, regardless of symptoms. These inhalers help the airways to relax and make breathing easier for the patient; however, they are not a treatment for inflammation of the lungs. Long-acting reliever inhalers should not be used on their own, but with a preventer inhaler; this is because they work together to reduce the patient sensitivity to asthma triggers. If you are not using this combination, you should talk to your GP.  
 

2. Preventer inhalers

Just like the name suggests, preventer inhalers help prevent asthma symptoms. They do this by reducing the inflammation in the airways, they contain a low dose of steroid medicine. The preventive effects of this type of inhaler builds up over time, which will mean you having to use the reliever inhaler less. Preventer inhalers should be used twice a day, even when you are feeling well. The dose can be adjusted by changing the strength of the inhaler rather than the frequency of use.
 
The Royal College of Physicians advise people to ask themselves three questions to assess the  severity of their asthma²: 

- In the last month/week have you had difficulty sleeping due to your asthma (including coughing symptoms)?

- In the last month/week have you had your usual asthma symptoms (eg, coughing, wheezing, chest tightness, shortness of breath) during the day?

- In the last month/week has your asthma interfered with your usual daily activities (eg, school, work, housework)?

If the answer is yes to any of these questions, it means that your current treatment isn’t working correctly and you should contact your GP as soon as possible.

If you would like to discuss your asthma with Dr Webberley, OOP’s dedicated GP, then please get in touch. She can go through your current symptoms and current treatment regime and discuss any recommendations for changes with you. If you would like to discuss your asthma with a private respiratory physician, then this can also be arranged for you.

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1.     http://www.asthma.org.uk/News/thousands-at-risk-life-threatening-unsafe-prescribing accessed 18/06/2015
2.     https://www.rcplondon.ac.uk/publications/measuring-clinical-outcome-asthma accessed 18/06/2015