Many of the 400,000 people with asthma in the Republic have their disease poorly controlled, new research has shown. It found the management of asthma here falls short of recommended international guidelines.
The study of 400 patients with asthma found that 27 per cent had to make an emergency visit to a hospital or their GP in the previous year because of worsening asthma symptoms.
Almost one in five experienced sleep disturbance at least once a week because of asthma. And 30 per cent had missed work or school because of flare-ups of their respiratory disease.
The Asthma Insights and Reality in Ireland (AIRI) survey was carried out by the Asthma Society of Ireland to determine the level of asthma control in a representative sample of people with the condition. Dr Patrick Manning, Dr Peter Greally and Dr Eamonn Shanahan, members of the society's medical committee, published the results in the current issue of the Irish Medical Journal.
Irish asthma guidelines, published in 2000, are based on the Global Initiative for Asthma (Gina) international asthma management guidelines. They define good asthma control as a patient having minimal chronic symptoms of wheeze, cough and shortness of breath.
Exacerbations of the disease should be infrequent or absent and the patient should not require emergency visits to a hospital or doctor. Nor should well-controlled asthma lead to limitations on daily activities, including exercise.
"Daytime disruption due to coughing, wheezing and shortness of breath or chest tightness were reported by 50 per cent of children and 58 per cent of adults," the authors said. "Thirty per cent of children and over 25 per cent of adults experienced sleep disturbance due to asthma."
Some 43 per cent of children missed on average 10 days from school and more than one in five adults missed an average 12 days from work due to their asthma.
Emergency visits to a GP or a hospital A&E department were made by 26 per cent of children and 18 per cent of adults with asthma. Some 8 per cent of children and 6 per cent of adults needed hospital admission because of a worsening in their condition. Although only 8 per cent of those surveyed achieved complete asthma control, the results are slightly better than those from a similar European survey.
"Commonly cited reasons for poor asthma control include under-
estimation of asthma severity and over-estimation of control by the patient, under-use of inhaled steroids and other add-on asthma-control therapies, non-compliance and poor inhaler technique," the authors said.
Acknowledging that a combination of patient and professional factors needed to be addressed to improve the control of asthma, lead author Dr Manning, consultant in respiratory medicine at the Bons Secours Hospital, Dublin, said yesterday: "I would like to see patients visiting their GP twice a year specifically for assessment of their asthma.
"Perhaps the GP-only medical card could be extended to children with asthma to facilitate this?"