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From the &Jitor. .... Arming asthmatics with knowledge
It seellls that pallent education and the prmlsion of detailed treatment plans could IX' the most valuahle components of an asthma management programme.
Patients with asthma are still dying from the disease . despite the availability of a wide range of prophylactic and symptomatic therapies. togetl1l'r w'ith a variety of sophisticated dclivLTY systeIlls.
Results of a rccent study. summari~L'd in last week's Inpharma I,d). indicated that l Jniversity students demonstrated an alarmingly low level of knowledge cOllcerning their asthma. particularly in the management of acute attacks. And this in a presumably intelligent study sampk. The results appear particularly disheartening because of the ready a\ailability of ctTective therapies. The recently published guidelines issued by the British Thoracic Society [see II/filial'll/a 759. 10, ::0 Oct 1990) outline clear. step by step. management programmes for acute and chronic asthma therapy. Starting with the intermittent usc of inhaled bronchodilators for the control of mild and infrequent attacks. therapy progresses to increasingly aggressive approaches involving inhaled and oral steroids. xanthines. bronchodilators and mast cell stabilisers for severe asthma. In the acute situation. prompt management is required and can include oxygen and inhaled heta agonists. high doses of systemic steroids. IV aminophylline and correction of electrolyte imhalances. Patients should be fully aware of the dosage schedules of prescrihed agents. and of changes in dosages allowed for the management of acute attacks. Integral to the management of asthma is the correct use of inhaler devices. and patients should have their inhaler technique cheeked regularly after initial demonstrations.
Crucial to the management of asthma at any level are assessments of lung function . All asthmatics should be provided with a peak flow meter and instructed in its usc. Underappreciation of the severity of the acute attack has frequently been cited as a cause of asthll1:1 t: lt:llltiL's: rl'gular USl' uf a l k'ak tlC)\\
t11L'kr pr(\\lties Ubjl'l·tl\l' baselIlll' Il1L'aSUres :H!.a lllq \\ hlL'h t(l , ' \1I1l1:llL' th l' ~l'\l'i'lt ~ of Zlll altack I 'l'~l~ ilo\\ rnL-' lL'i:') (~in alsZ) :ndH . .'atc imllro\Cllll'llts III tlK cOllditi(ln. p()ssihl~ al!o\\lng tlh,'!'ap\ \1.lt hdr:I \\;lI or rCLiU(\IOIl \\llh a l'(\ IlCUIT L' 1lI delTL' aSL' III Ihe i'lsk of drug- Induced
2 If) SOl' 19f10 ISPI/ARM,.""
reca ll of \ ,'rbalinforl1latlon \\ ill often be limited. ,'sIKclall y dUi'lng all <leutl' attack. a ll spoken Instructions should be reillforced wilh written Informati on. '\'sthma socil'lIl's oftcn pro\ltk llsl' flll \\J'lttl'n matl' riai and hulLl L'dUCallGn3! l11eellni!s and referral of a new patll' nl to th e rek\ant SOCIl'tl might bL' as \aluabk as a drug prescri plIon. C; Ps. l;o5pi tal spl'cial ists. asth ma ~uppurt groups and pharmaClsls l'an all be \aluabk pro\ldcrs of Information and support fur asthmatll'S: \\ itllOUI this educational roll' II see lllS Ihat thl..' P('()\ ISlon o f prescnpiiull l11l'diClnl' s \\ IiI be Il1suftil'icnt to pre\L'nt mnrbldil\ and monalIt\ from asthma.
ISS/\' 0156·2703/ 90/ 11 /o·0002/ 0$f)I .IIO/ () ' · Adi.1 InTernaTional Ud