The Global
Burden of Disease (GBD) study has estimated that India is home to over 30
million asthmatics, accounting for 13.09% of the global burden. However, when
it comes to mortality, India accounts for over 42% of all global asthma deaths.
Despite being a leading cause of morbidity and mortality, the disease continues
to be undiagnosed and untreated for years. Population-based studies done
globally, have estimated that 20% to 70% of patients with asthma remain
undiagnosed and hence untreated.
The various
contributory factors for under diagnosis and under treatment of asthma include
lack of disease awareness, poor adherence to inhalation therapy, illiteracy,
poverty, and social stigma. The patients often overlook their early symptoms
which eventually lands them in a more critical condition. According to the
Global Asthma Network (GAN) study, 82% of patients with early symptoms and 70%
of patients with severe asthma, remain undiagnosed in India. The percentage of
adherence to the optimal treatment is also very low among diagnosed patients,
with less than 2.5% of patients using daily inhalation therapy.
Asthma, often
referred by lay public as ‘swas’, ‘dama’, or ‘cold and cough’, is a chronic
respiratory disease that causes difficulty in breathing, chest pain, cough, and
wheezing. The disease affects the airways of the lungs, causing chronic
inflammation, which makes the airways more sensitive to triggers thereby
increasing the chances of asthma attacks.
Citing the GAN
study, National Coordinator Dr Virendra Singh stressed on the importance
of addressing the social stigma towards asthma. “When an asthmatic patient
consults a doctor, only 71% of doctors give the diagnosis of “Asthma” as the
name of their disease while close to a third (29%) use other terminologies.
Also at the patient level, only 23% asthmatic patients call their disease as
asthma. Social stigma associated with asthma and use of inhalers is prevalent.
Further, patients barely adhere to medication and mostly take symptom driven
treatment. Awareness, Acceptance and Adherence need to be aligned to win
against asthma.”
Dr Virendra
Singh, Director Asthma Bhawan and President Rajasthan Hospital highlighted,
“Asthma is considered as a stigma and many patients conceal the disease. It is
only when the symptoms aggravate or are intolerable a patient consults a
physician and will take the medication that is prescribed. We need to keep
reminding patients that Symptom-free is NOT asthma-free. This remains one of
the biggest challenges in asthma management. Many patients discontinue using
inhalers once they feel better. This discontinuation often leads to flare up of
symptoms which can worsen disease outcomes. Further,incorrect notions such as
inhalers being harmful and habit forming also play a role in treatment
non-adherence. Hence this needs to be addressed aggressively”
The need of the hour
for patients is to gain timely consultation with a physician, which will help
him get the right information and diagnosis for his symptoms and start with the
right treatment early on. Timely diagnosis is very important to manage asthma.
Understand your asthma symptoms and consult your doctor.