Public awareness key to effective control of asthma

Experts said without a proper understanding of asthma and its triggers, it could become fatal if not properly managed, noting that many people perceive asthma as a "normal" illness, with no immediate treatment needed.

Asthma, a common non communicable disease (NCD), affects about two million people in Malaysia with 90 per cent of the cases uncontrolled.

Uncontrolled asthma relates to an increase in emergency department visits, hospitalisations, and work and school absenteeism and could potentially decrease life expectancy.

Statistics have shown that in Malaysia, the number of deaths due to asthmatic complications annually is around four digits with about 1,700 cases reported in 2014.

This figure may be considered small if compared to other causes of death, but experts said, most death cases due to asthma cases can be avoided if early and proper treatment is given.

According to Dr Mat Zuki Mat Jaeb, Senior Consultant Respiratory Physician at Hospital Perempuan Zainab II in Kota Bharu, Kelantan, accurate classification will be the first step to treat and manage the disease more effectively.

He said asthma is classified as mild, moderate and severe while assessment is based on, among others, types and dosage of medication needed by patients to control their condition.

"Public awareness toward three different levels of severity is still low. Every level requires different approach to treatment.

"Severe asthmatic patients need special attention as they are more prone to having frequent asthmatic attacks despite being skilful at administering the inhaler correctly. This is because of other factors which contributed to severe attacks, such as the extremely high level of white blood count.

"These patients not only suffer from sleep disorder daily, but also their daily activities are also limited. They also become overly dependent on medication for immediate relief such as inhaler and steroid oral (OCS) daily and for the long term," said Dr Mat Zuki recently.

He however said the use of OCS for a long period can lead to various health risks such as diabetes, osteoporosis, heart disease and obesity.

DISEASE MANAGEMENT

Dr Mat Zuki believes that asthmatic patients should have the knowledge and self-awareness about their own illness, failing which asthma management will render less effective in most cases.

"Experts found that many asthmatic patients are not fully motivated to control their illness. Some patients use asthma as an excuse to refrain from carrying out physical activities such as exercise or avoid from going to school or work.

"While the lackadaisical attitude does exist among patients, it is still crucial that they be empowered with such education and become more actively involved in disease management. Patients must be guided on understanding the signs and symptoms of asthma to help them identify the right time to get their medical treatment.

"Early and accurate treatment, coupled with frequent visits and adherence to follow-up treatment are some of the vital aspects of proper asthma care.

He said poor management of asthma will affect the quality of life of a patient, especially when it is not detected early by the doctor and not treated well.

"Usually asthma attacks can cause the patient to feel tired and lethargic during the day. This could affect his or her performance at work and student school attendance in addition to increasing the risk of accidents.

"It can also impact the economy due to poor work productivity and loss of income, as well as the rising costs associated with asthma," he added.

DIAGNOSTIC CHALLENGES

At the same time, he said asthmatic patients in Malaysia are confronted with the challenges of obtaining accurate diagnosis and treatment.

He said, while experts are cognisant of the existence of the technological advancement and diagnostic facilities for asthma in Malaysia, the facilities are not fairly distributed, hence limiting patients' access to comprehensive diagnosis.

Besides improvements to diagnostic access, exposure to the latest treatment and medications should also be extended, especially for severe asthmatic patients, he said, adding that patients from the rural areas are constrained by costs and distance when seeking better medication.

As part of efforts to improve the treatment for severe asthma cases in Malaysia, Dr Mat Zuki is spearheading the PRECISION Severe Asthma Working Group in collaboration with AstraZeneca Malaysia, with involvement from renowned respiratory medicine experts and healthcare professionals from local public institutions.

This group is expected to finalise the diagnostic framework for managing asthma and experts' referral system for severe asthma sufferers.

It is also seeking a consensus among local experts to contribute in terms of guidance towards the setting up of a clinic which provides specialised and high quality treatment for severe asthmatics.

In addition to a special clinic which has been set up at Hospital Raja Perempuan Zainab II to treat severe asthma cases, it is also working closely with a group which provides expertise in respiratory medicine; ear nose and throat (ENT) as well as in the general treatment of asthmatic patients.

"Patients who are referred to us (at the related clinic) including those with long term OCS treatment, those who have receive emergency treatment at the hospital and admitted to the intensive care unit (ICU) due to asthma, as well as those who use three or more reliever inhalers with the last one year," he said.

COLLABORATION ACROSS BOUNDARIES

Meanwhile, on the tie-up, Country President AstraZeneca Malaysia Dr Sanjeev Panchal said the PRECISION programme, which is a global initiative, is a close collaboration between AstraZeneca and various stakeholders across boundaries in healthcare to develop and improve the medical healthcare outcome of asthmatic patients.

In Malaysia, PRECISION Severe Asthma Working Group focuses on efforts to facilitate the referral system in healthcare to ensure a more effective healthcare delivery, strengthen the capacity for accurate diagnosis, increase the capacity for treating severe asthmatic cases and raise awareness on severe asthma as a serious illness which needs more attention from policymakers.

Given that Malaysia is among the key healthcare tourism destinations in Asia Pacific, the development of the healthcare ecosystem through high quality facilities, the smooth flow for patients as well as the increased availability of services that are dedicated to severe asthma, will place Malaysia in good stead as among the primary hubs for asthma care.

"As such, our efforts at improving the health facilities for asthma cases of all levels...would augur well for Malaysia which has built a strong reputation as a safe and trusted leading global destination of choice for healthcare, with its holistic ecosystem," he added.