Most with asthma overusing inhalers


Overuse linked with exacerbations and death
Asthmainhaler - Most with asthma overusing inhalers
  • Deborah Condon

The Asthma Society of Ireland has expressed concern about the number of people with asthma who overuse their reliever inhaler, a practice that has been linked with severe exacerbations of the condition and asthma-related death.

Reliever inhalers, which most people recognise as the blue inhalers, are used to widen the airways and reduce asthma symptoms in the short term. They are a key part of treating an asthma attack.

According to the Global Initiative for Asthma (GINA), using three or more reliever inhalers a year indicates a person is at risk of a severe asthma exacerbation, which is a progressive worsening of symptoms.

Furthermore, the use of 12 or more reliever inhalers a year is an indication that someone is at risk of an asthma-related death.

Research carried out on behalf of the Asthma Society has revealed that three in 10 people with asthma in Ireland use more than 12 reliever inhalers a year, while seven in 10 use more than three per year.

The research also found that within five years of diagnosis, half of people with the condition are over-reliant on their reliever inhaler.

In the year after diagnosis, 30% of children aged under 17, and 60% of people over the age of 50, are overusing them.

The results were described as “stark and very worrying” by the society’s CEO, Sarah O’Connor, who noted that one person dies every six days in Ireland as a result of asthma.

“This research revealed that a huge proportion of people in all age groups are overusing their reliever inhalers in every county throughout Ireland, putting them at risk of a severe exacerbation or asthma-related death.

“Alarmingly, within five years of diagnosis, half of people become over-reliant on it. As people with asthma get older, their rate of over-reliance increases, resulting in increased levels of uncontrolled asthma,” she said.

The counties with the highest rate of overuse were found to be Carlow (56%), Waterford and Limerick (both 53%), and Dublin, Monaghan, Tipperary and Offaly (all at 52%).

Ms O’Connor pointed out that a key point at which people become over-reliant on their reliever inhaler is between year one, the year of diagnosis, and year two.

“This year two of asthma is when the largest increase in inhaler over-reliance occurs and we need healthcare professionals to know this so that they can intervene to help and support their patients to have the best possible asthma management,” Ms O’Connor insisted.

She explained that if you are using your reliever inhaler several times each week, then you are over-reliant on it and your asthma is not controlled. The exception to this is people with asthma who participate in sport/exercise, as it is still recommended that you use your reliever inhaler prior to warming up before you exercise.

The Asthma Society is calling on all people who are over-reliant on their reliever inhaler to take the following actions:
1. Download an Asthma Action Plan from here
2. Complete your Asthma Action Plan with your healthcare professional and speak specifically about your asthma medications
3. Call the Asthma Society’s free Asthma and COPD Adviceline on 1800 44 54 64 to help you understand asthma, its triggers and how to manage it, and to better understand your asthma control.

“A reliever inhaler works within minutes to relieve asthma symptoms when they happen. It gives a short-lived improvement in symptoms, effectively just buying time, but can eventually fail to keep a patient safe from asthma if more appropriate and effective controller inhalers are not used on a daily basis,” explained the society’s medical director, Dr Marcus Butler.

He noted that a controller inhaler works over a much longer duration than a reliever inhaler, to eventually ease the underlying airway inflammation, which ultimately causes asthma symptoms.

“This prevents symptoms from arising several weeks and months down the road, as long as it is habitually taken,” he added.

To reduce asthma-related deaths and exacerbations, the Asthma Society of Ireland has launched its Asthma SafetyCare campaign, which aims to end asthma deaths in Ireland by making patients and the public more aware of asthma management issues.

The Asthma Society hopes that this campaign will make a difference to asthma deaths by combatting problematic aspects of asthma management, such as the overreliance on reliever inhalers.

The research was carried out by hmR Ireland.

For more information on asthma or the Asthma Society, click here or call the Asthma Adviceline on 1800 44 54 64.


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