CHENNAI: Uninterrupted inhaler therapy is essential for gaining good control over asthma, according to respiratory physicians who have raised concern over the tendency of patients to discontinue the use of inhalers once they obtained relief.

Absence of symptoms does not mean absence of disease and asthmatics should continue the inhalation therapy to achieve good control, said experts on Thursday ahead of World Asthma Day on May 3 on the theme `The Unmet Needs of Asthma.'

Inflammatory disorder

Asthma, which is a chronic inflammatory disorder of the airways, can be controlled but not cured. The projected increase of the asthma burden in the world's urban population by 2025 is from 45 per cent to 59 per cent. It is now estimated that 300 million people of all ages are affected by asthma and that the disorder accounts for one in 250 deaths occurring worldwide.

In India, out of an estimated 20 million patients, only 3-4 million get proper treatment. A majority — nearly 14 million patients — do not have adequate control over asthma and lead compromised lives. They frequently miss work or school, find it difficult to enjoy a good night's sleep, refrain from physical activity, are often hospitalised and may even avoid social interaction because of the stigma associated with asthma.

Paradoxically, though the problems caused by asthma can be almost completely prevented, many people, especially parents of asthmatic children, refuse to accept a diagnosis of asthma, or shy away when the doctor prescribes inhalation therapy, said R. Narasimhan, consultant Apollo Hospitals and chairman, Respiratory Research Foundation of India.

The results of a 15-point questionnaire distributed by the Foundation recently found that 50 per cent had not been informed by physicians that steroid should be used regularly and only 30 per cent used inhalers as advised to.

While 42 per cent of the patients used inhalers on a need basis alone, 10 per cent did not use it at all under the wrong impression that it led to steroid addiction, was bad for the heart or was to be used sparingly in case of a serious asthma attack.

Cost factor

Raj B. Singh, consultant, Apollo Hospitals, pointed out that economically backward patients could be keeping away from inhalation therapy because of the cost (an expense of Rs. 3 per day on average).

He recommended that subsidised inhaler therapy be made available in Government hospitals for the low-income groups.

P. K. Thomas, Apollo Clinic and R. Sridharan, Asthma and Allergy Resource Center, said the rise in asthma could be attributed in part to urbanisation and pollution, though there has been no study to definitively establish the linkage.

K. Venugopal, Sooriya Hospital, said some of the colouring/flavouring agents used in preparing junk food are also suspected to set off asthma.

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