Asthma control can be achieved

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27-year-old Mark had asthma but always seemed to manage it well and since he didn’t need his inhaler all the time, he didn’t always have one readily available. At 3:15 a.m., Mark’s mom, Maureen, got a call from him saying he was having trouble breathing. With no history of major asthma problems, a call to 911 seemed dramatic but Maureen encouraged her son to make the call immediately, which he did. By the time the ambulance arrived at his home, Mark was gone.

In Canada, an estimated three million people live with asthma and more than 300 die every year because their asthma is not under control.

At one time, those diagnosed with asthma just accepted that they had limitations. Today, they should expect that with proper management through medications and lifestyle changes, total control can be achieved. “One of the biggest advances in asthma management over the last five years is the combination, single therapy inhaler,” said Dr. Lisa Cicutto, Associate Professor, University of Toronto, Faculty of Nursing. “With the advent of combination inhalers, we are able to provide the patient with a simplified regime that makes it easier to achieve asthma control.” Studies indicate that patients using the combination inhaler achieved well-controlled asthma over the course of one year.

The Canadian Asthma Consensus Guidelines have also played a role in the attitude health care professionals have adopted that asthma is controllable. “We are co-defining the evidence in the Guidelines for health-care professionals to access. The Guidelines deliver a consensus on the common challenges and treatments. This is important as it takes into account many aspects which affect a person’s asthma such as allergen avoidance, air quality and nutrition,” stated Dr. Gerard Cox, Director, Division of Respirology, McMaster University, Acting Clinical Director, Firestone Institute for Respiratory Health and President, Canadian Thoracic Society.

The Canadian Asthma Consensus Guidelines can be accessed at www.lung.ca and the Adult Asthma Care Guidelines for Nurses: Promoting Control of Asthma can be found at www.rnao.org.

The Lung Association’s Asthma Action Helpline has made a significant difference in the lives of people with asthma since its launch. The Helpline serves approximately 3,500 people with asthma and their caregivers each year and to date has received over 19,000 calls. Calls are answered by specially trained Certified Asthma Educators who respond to questions about asthma control, medication use and environmental concerns. Callers are provided with a tailored-education and counseling session to meet their identified needs. An evaluation of the Helpline reveals that most callers have poorly controlled asthma and are advised to visit their asthma care provider to discuss options for improving their level of asthma control. The evaluation suggest most callers return to their asthma care provider and have subsequent improvements made to their management approach that result in improved asthma control.

The Canadian Pediatric Asthma Consensus Guidelines will be released later this month in the Canadian Medical Association Journal. Focusing on infants and children, the Guidelines will offer pediatric health-care providers with more information on diagnosing this group. Historically, it has been a challenge to diagnose young children since objective lung function tests cannot be used with infants and young children.

The University of Toronto, Faculty of Nursing and The Lung Association are working together to meet the needs of schools by developing a resource kit for asthma in schools slated to launch in the fall of 2005. A recent survey indicates that less than one-third of teachers in Ontario are confident in their ability to help a child with asthma.