Asthma is one of the most common chronic respiratory conditions seen in primary care in Singapore5; it is usually characterized by chronic airway inflammation1 that can be triggered by a host of factors including allergens, cold air, tobacco smoke and exercise. As a result, symptoms such as wheezing, chest tightness and shortness of breath occur.
For many asthma patients, it is possible to experience remission, i.e., going 12 months or longer without significant symptoms or the use of the reliever inhaler (also commonly known as “blue inhalers”), in addition to improved overall lung function. The key to long-term asthma management is to determine the root allergens that are the causes of asthma attacks, and to treat your airway inflammation with preventer medication such as inhaled corticosteriods. This, in turn, will lead to fewer doctor visits, less reliance on the reliever inhaler and an ability to live a normal, fulfilling life!
Find out if you are on the right track below.
How well do you manage your symptoms?
To know how well you have been managing your condition thus far, you could ask yourself these 4 questions1:
Over the past 4 weeks,
- Did you experience daytime asthma symptoms (such as coughing, wheezing or breathing difficulties) more than twice per week?
- Did you have any night waking due to asthma?
- Did you turn to your reliever inhaler for symptom relief more than twice per week?
- Were there any activity limitations due to asthma?
If you have answered “no” to all these questions, you have been managing your symptoms effectively and should continue with the strategies you are currently employing.
However, if you answered “yes” to 1 or 2 of the above questions, you should double-check and make sure you follow the treatment as prescribed by your medical professional. If you have answered “yes” to 3 or more of the questions, then it may be time to call up and make an appointment with your doctor as you might be at risk of a severe asthma attack.
Using three or more reliever inhaler canisters per year is associated with twice the likelihood of hospitalisation1, and anything more than 12 canisters per year is associated with an increased risk of asthma-related death2.
Consequences of poor asthma control
Being unable to control your condition well might also affect your well-being, such as feelings of anxiety, low mood and lower productivity in general.
You could try to keep your symptoms under control by taking your prescribed preventer inhalers, identifying and avoiding your asthma triggers where possible and working with your doctor to create an asthma action plan. If you experience the early signs of an asthma attack, seek help from a medical professional immediately.
Preventer vs Reliever inhalers
As shared, asthma is a respiratory disease characterized by airway inflammation1. Preventer inhalers typically contains corticosteroids and works by reducing this inflammation. On the other hand, reliever inhalers provide immediate relief to asthma symptoms by dilating the airways once they are administered upon experiencing the symptoms.
Preventer inhalers may take up to a few hours to take effect. Since they do not provide immediate relief, they are often not used during a sudden asthma attack.
As such, many patients tend to overuse their reliever inhalers as they perceive the quick relief to be effective; holding the misconception that preventer inhalers aren’t effective due to its slower onset of action.
Unfortunately, this poses a serious problem both in the short and long term, as the overreliance of your reliever inhaler could be masking symptoms and a worsening asthma inflammation.
Living with COVID-19 and asthma
Many people with asthma might have concerns about whether they are at a greater risk of contracting COVID-19; however, a Singapore study actually showed a reduction in asthma admissions during the lockdown period in 20203. Similar results have been reported in England during the national lockdown with fewer exerceberations4. While the reasons are not entirely clear, it is a possible consequence of public health measures such as social distancing and greater emphasis on hand hygiene and mask-wearing.
The key takeaway here is that systematic reviews have not shown an increased risk of COVID-19 in people with well-controlled, mild-to-moderate asthma. Thus, it is vital for people with asthma to focus on good asthma management in collaboration with their doctor; incorporating new and existing strategies to manage their condition and reduce the risk of severe exacerbations.