ADELAIDE: People with asthma who only use ‘quick fix’ reliever puffers could be running the gauntlet with their health, according to new research showing one in four require urgent medical treatment every year.

Presented today at the Australasian Asthma Conference a study led by Woolcock Institute of Medical Research in Sydney surveyed almost 2700 people with asthma and found 39 per cent only used a reliever medication, treating their symptoms but not the cause.

“Worryingly, a quarter of patients who used the reliever only, and no preventer medication, were forced to seek last-minute treatment for a dangerous flare up in their condition,” says Professor Helen Reddel, lead author of the study published in the journal BMJ Open. “This is hard proof that people who choose to only treat symptoms as they arise, without also treating the underlying condition, run a very real risk of winding up in hospital.”

About 2.3 million Australians have asthma but many are not being treated according to national guidelines which recommend they use a preventer inhaler every day, even when they have no symptoms. Instead, many people resort to reliever-only medication which leaves their condition poorly managed.

Michele Goldman, CEO of Asthma Australia says reliever-only treatment is an option for people with mild infrequent asthma;

“Only people who have infrequent asthma symptoms and use their reliever less than twice per month, and who have no risk factors for asthma flare-ups should use a reliever-only treatment approach. We know that around half of people with asthma are using their reliever on more than 2 days a week, meaning their asthma may not be well controlled and they are over-reliant on this quick fix. The research shows that some people who feel their asthma is mild are still experiencing symptoms and should actually be taking regular preventer medication, but the message is not getting through.”

Woolcock researchers, with colleagues in Sydney and Melbourne, investigated this vulnerable group of reliever-only users and found they were more likely to be younger and male. Results showed 23 per cent had urgent treatment for their condition in the past year, and just over 70 per cent of these were suffering symptoms consistent with poorly-controlled asthma.

“This urgent healthcare group tended to be really frustrated with their asthma and unhappy with how they were managing it,” Professor Reddel says. They were also more likely to live in fear of a severe asthma attack despite taking their reliever medication as instructed. And dangerously, they were more likely to try to manage worsening asthma themselves rather than see a doctor, even though they doubted their ability to intervene early to prevent their symptoms worsening.

“This study paints a disturbing picture of life with asthma for many of those using only a blue reliever inhaler,” Professor Reddel says. “They’ve got their short term relief covered – a puff and they’ll feel better for a few hours – but it does nothing to treat the underlying problem.”

The results show doctors and other health professionals are currently failing to capitalise on opportunities to reach out to these patients. Clinical practice must improve to consistently identify those at this unacceptable risk, improve their expectations for asthma control and deliver optimal evidence-based asthma management.

“Forty-five per cent of Australians with asthma have symptoms that are not well controlled.  Many people put up with frequent asthma symptoms that not only have impacts on quality of life, but also place them at risk of a life-threatening asthma flare-up. We need to better educate people that good asthma management is possible and really improves lives,” says Ms Goldman.

Professor Reddel says; “One thing that is clear from our findings is that we can’t sit back and be complacent about asthma. We need urgent changes to both the prescribing and use of medications to protect thousands of Australians from suffering serious health problems from ill-managed asthma.”