Medical Notes: Asthma sufferers should get the right inhaler and improve their technique

Two types of inhaler are associated with asthma, preventer and reliever – both must be used to properly manage the condition
Greg Miller

ASTHMA, readers unfamiliar with the condition might be surprised to learn, is a potentially fatal condition; in fact, last year 44 people in Northern Ireland died from an asthma attack, the highest number of such deaths since 2004.

To reduce or, ideally of course, eliminate deaths from asthma, I believe we need to manage asthma more effectively and one way we can do that is by getting better at using the treatments we already have available.

Asthma attacks are caused by the airways in the lungs narrowing, making it more difficult to breathe. This happens because of inflammation in the airways, which then become overly sensitive to triggers that cause the muscles around the walls of the airways to tighten.

A recent National Review of Asthma Deaths (NRAD) report claims people are still needlessly dying from asthma attacks and putting themselves at risk by not using their inhalers correctly.

Treatment of asthma involves using both a ‘preventer inhaler' to stop the airway becoming inflamed and a ‘reliever inhaler' to relax the muscles and open up the airway.

The report found that many patients were relying only on reliever inhalers to control their symptoms and were not using their preventative inhalers to treat the underlying inflammation associated with asthma.

Unfortunately this theme of underusing the preventer inhaler and overusing the reliever is all too common; and we need to highlight and educate patients about the importance of using the preventative inhalers to keep the underlying inflammation under control.

In Northern Ireland, an estimated 1 in 10 people or 182,000 people are currently receiving treatment for asthma. So it's really important that if you or a loved one has asthma, that you understand which inhalers to use and how to use them.

Get the right inhaler and improve your technique.

Patients need to have good inhaler technique to make sure the drugs can get deep down into the lungs where they need to work. Unfortunately, we know that inhaler technique isn't always perfect and if it's poor, only a small fraction of the medicine gets down into the lungs, making it less effective. Having good inhaler technique and getting it checked regularly is really important.

The NRAD report found that only 49 per cent of patients had their inhaler technique checked in the year before their death.

Where can you get inhaler technique checked?

Most patients will get their inhalers checked at the GP surgery. When you first get your inhalers, you'll be given an explanation of the different inhalers and how they help treat asthma. You should ensure you get your technique checked again at regular intervals to ensure you're using your inhalers to best effect.

You can also have your inhaler technique checked and ask about asthma treatments from your local community pharmacy under the Medicines Use Review (MUR) service. The pharmacist will review your medicine and you get a chance to see how your inhalers can be used to get the most benefit.

Asthma is a manageable condition with devastating consequences, if not managed properly. Better use of inhalers means better asthma control as well as the potential to save lives.

USEFUL WEBSITES for finding out more about inhaler technique and treating asthma

:: Managing your asthma

:: Using your inhalers

:: Self-management plans (Asthma)

:: For further information on this service and how Medicines Use Reviews can help you get the most out of asthma treatments, ask your local pharmacist next time you pick up your prescription.

:: Greg Miller is a pharmacist with the Pharmacy and Medicines Management Team at Northern Ireland's Health and Social Care Board.


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