Inhalation therapy is considered to be the gold standard for the treatment of asthma with current guidelines recommending long-term treatment with inhaled corticosteroids because of their superior effectiveness in managing the chronic airway inflammation that characterizes persistent asthma.1
Unfortunately, till date, there is social stigma attached with asthma and use of inhalers by asthmatic patients. Various research studies have found stigma to be associated with high morbidity in asthma patients. The social stigma of the asthma is one of the contributing factors to the anxiety faced by patients. The likelihood of being depressed has been found to be twice in asthma patients as that of normal individuals.
Dr Vijay Mandora, Consultant Physician, Inlaks Hospital Pune says,” Stigma, often coupled with asthma, can lead to non-disclosure of the disease, self-blame and embarrassment over medication use in public. A large majority of care givers and patients have reservations about the use of inhalers only because of social stigma attached with inhaler. Many a times they do not even learn the proper technique of inhaler use. People living with asthma often feel that they will be treated as outcastes, which leads to feelings of despair and denial causing poor prognosis.”
According to Global Asthma Report (2014), symptoms of asthma especially breathlessness are responsible for fear, emotional and psychological suffering of patients living with asthma. The stigma attached with asthma is one of the major barriers, as it can delay health seeking, case detection and decrease the adherence to long-term asthma management regimens2.
Also, the stigma associated with asthma may impinge negatively on the quality of life of innumerable patients. Asthma patients never feel at ease using asthma medications (in particular inhalers) in public because doing this often makes them feel stigmatized.
Experts feel it is important for people to understand that inhalers are sign of health, not illness. They are nothing but a kind of drug delivery system which helps asthma drugs to reach the lungs directly and bring immediate relief to the patient.
Dr. Kapil Borawake, Consultant Physician at Prayag Hospital and Sahayadri Hospital, Pune, says, “It is unfortunate that in India, almost 80 percent of asthmatic patients are on oral medications, due to fear and stigma associated with inhalers. Oral medications lead to more side effects and are required in large dosages whereas inhaled corticosteroids reach the lungs directly, thus requiring only small amount to be administered.”
There have been numerous scientific studies stating that taking medication for asthma through inhalation is an effective way to treat asthma since it reaches the lungs directly and starts acting immediately. According to a study published in ISRN Allergy (2013), in comparison with oral formulations, inhalation therapy ensures that small therapeutic doses of drugs are delivered topically into the airways causing local effects within the lungs3.
Inhaled corticosteroid therapy is highly effective in reducing inflammation of airways, improving pulmonary functions, easing asthma symptoms and reducing asthma exacerbations. Its regular use has been associated with substantial reduction in the rates of hospital admissions and rate of deaths from asthma4.
So, it is very important for caregivers to ensure that stigma doesn’t prevent patients from availing the benefits inhalation therapy has to offer. It is important to put the patient’s mind at rest and to assure him that he is doing the right thing by opting for inhalation therapy. The patient needs to understand how it is going to improve his quality of life. After all, people living with asthma have the right to live free with inhalation therapy.
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