Around 11 per cent of all asthma hospitalisations in Australia are for people aged over 65 and with the condition causing breathlessness, coughing and wheezing, researchers believe they’ve created a new inhaler that can cut the risk of asthma attacks. Asthma attacks can occur suddenly or over a few days and can be extremely distressing for the person experiencing them.
Researchers now say that a simplified combined inhaler treatment reduces the risk of severe asthma attacks by a third compared to other commonly prescribed treatments. Many people with asthma currently use steroid-containing preventers to keep symptoms at bay and a separate reliever that relaxes bronchial muscles for when wheezing happens, but Australian and New Zealand researchers believe doctors need to change the way they treat the common respiratory illness.
A year-long trial involving 890 New Zealand adults found there was a 31 per cent reduction in severe asthma attacks in people who used the simplified, combined inhaler treatment. Between 10 and 15 per cent of adults suffer from asthma and the new findings could give new hope to these people.
“The findings from this study are incredibly exciting and will undoubtedly change the way doctors treat mild and moderate asthma worldwide,” study author Richard Beasley said in a statement. “The results provide new evidence supporting recent major changes in the management approach recommended in international asthma guidelines”.
At present, most people experiencing moderate asthma use a preventer twice a day to reduce symptoms and a separate reliever to take whenever they need to relieve worsening symptoms such as wheezing. Researchers found that people aren’t likely to use both medications regularly, which could limit their benefit. The new study, published in the Lancet Journal, found that the use of a combined preventer and reliever in one inhaler taken only when a person needs to relieve symptoms is better at reducing asthma attacks than use of a separate preventer inhaler taken twice daily and a reliever inhaler.
As part of the study, participants were split into two groups, where one was asked to use a preventer inhaler twice daily and another inhaler when they had symptoms, while the second group only used a combination inhaler when they experienced asthma symptoms. Beasley explained: “This trial has confirmed our study published earlier this year in the New England Journal of Medicine, showing that when patients take just a single combined preventer-reliever inhaler whenever needed to relieve symptoms, they do a lot better than the previously recommended treatment of a regular preventer inhaler taken twice daily plus a reliever inhaler whenever needed.”
He added: “The greater benefit was achieved despite exposure to about half the amount of inhaled corticosteroid preventer medication because the inhaled corticosteroid works better when taken as needed in mild asthma”.
Researchers said the new approach simplifies treatment because it doesn’t require patients to take numerous medications – even when they don’t experience symptoms. They also found that using just one form of treatment takes advantage of a patient’s natural behaviour to use a reliever only when they’re experiencing symptoms.
“This independent study is important as it adds to a strengthening body of work showing that ‘take a puff when you feel you need it’ combination treatment is equivalent or better than regular preventer use for reducing asthma flares, but with a lower total burden of treatment” researcher Ben Brockway said. “People can worry about taking inhaled steroids regularly, but if you are an adult with asthma and struggle to remember to take your preventer inhaler, or only have a reliever inhaler, then there’s a very good chance that this simpler, easier regime will improve your asthma control”.
The study explained that for people with mild to moderate asthma, they would simply take the combined preventer-reliever inhaler when they have symptoms with no requirement for other inhalers. In severe asthma, patients would take the combined preventer-reliever inhaler daily both as a regular maintenance medication and also as a reliever when required.
People with asthma are also encouraged to create an asthma action plan, which helps them recognise a flare-up or worsening symptoms and advises them on what to do when this happens. The plans are individual, written by a GP and include information about doses and frequencies of medication, how to adjust treatment in the event of an exacerbation, managing severity of attacks, identifying warning signs and how exactly to seek urgent medical help if needed.
Of course, lifestyle factors can also cause asthma sensitivity and people should quit smoking and maintain a healthy weight to help reduce the risk of flare-ups. Other environmental factors including cold dry air, dampness in homes and fumes from wood-fire heaters or gas heaters can also affect your risk of an asthma attack and contribute to breathing difficulties.
It’s always important to talk about your symptoms with a GP so they can offer a medication that will work best for your symptoms.