What To Tell Your Patients

Education is key for asthma patients. It's the only way to control symptoms

By Julia Cyboran

Evelyn Bryer, 38 years old, had to reach for her asthma pump every time she climbed a flight of stairs. Out of breath and wheezing, only a dry, stale puff from her salbutamol inhaler provided relief � as it had done since she was 14. Her dependency on the puffer started worrying her ever since her pharmacist warned her that she was renewing her prescription too often and suggested that she speak to her doctor about other options. It was time for Evelyn to take control of her disease.

FIND RELEASE
Evelyn's case isn't uncommon. Many asthma sufferers don't have a full understanding of their condition and have trouble controlling it. According to results from the ongoing Alberta Study to Help Manage Asthma (ASTHMA), less than 30% of patients get asthma education and only about 60% actually use inhaled-steroids.

Another of ASTHMA's studies, also out of the University of Alberta, is currently evaluating a 'team' approach for tackling asthma. It looks at a communication network between pharmacists, GPs and respiratory therapists. The objective of the study is to measure the impact of a community-based program that includes patient education to optimize treatment and asthma control. Participants were divided into two groups � one receives regular care while the other is enrolled in an enhanced program, which includes a little extra when it comes to treatment. "In terms of the enhanced care group, we educate the patients on how to take care of themselves, like avoiding triggers; we teach them how to use their inhalers properly; we insist on the importance of taking their meds," explains Dr Ross Tsuyuki, one of the team's researchers.

Right now the project is based in the small town of Hinton, AB, and the project is showing promise. "There has been quite a bit of media coverage for our project," says Dr Tsuyuki. "From what I have seen from the interviews, the patients are happy. I do think they're getting better care."

The U of A project began in November and the collection of results will start in six months. In the interim, one message seems clear � patient education and communication are important factors in improving asthma care.

WHAT TO TELL YOUR PATIENTS •Avoid triggers Right off the bat, it's important that patients recognize what sets off their asthma. Triggers include allergic reactions to pollen, moulds, animals and dust; infections like the common cold, influenza and pneumonia; emotional stress and excitement; vigorous exercise; cold air and air pollution, such as cigarette smoke and car exhaust; and household products like paints, cleaners and sprays are all things that can set off an asthma attack. •Make lifestyle changes Quite simply, if the patient is allergic to cats, tell them to get rid of them. Quitting smoking is also a big one. Wall-to-wall carpeting can be a breeding ground for mould and dust so toss it out � it's an easy way to keep the air clean. Dr Irvin Mayers, the co-director of ASTHMA says that, "the first thing someone can do to help control asthma is to modify elements in their immediate environment." •Know when the drugs aren't working Renewing a prescription too often is one of the first signs that the asthma isn't under control. A patient who's picking up a new inhaler more than twice every three months has a problem. "It's important that patients make sure that they are using their medication effectively and optimally," says Dr Mayers. •Communication is key The absolute most important point to controlling asthma is communication. You can prescribe all the prescriptions in the world and educate your patients until the cows come home, but if the patient is not relaying the proper information to you, then all is for not. Patients need to tell their physician how often they are renewing their meds; if they feel shortness of breath or wheezing; or if they feel like the medication is working. Such subjective information can only come from the patient. Keep the lines open: patients shouldn't be afraid to ask about new drugs or other treatments.