Steps to achiev­ing bet­ter con­trol of your asthma.

Toronto Star - - MEDIA PLANET - Michele Spona­gle

Asthma has life-threat­en­ing and life-al­ter­ing con­se­quences and yet 9 out of 10 pa­tients have poor asthma con­trol.

More than 2.5 mil­lion Cana­di­ans have been di­ag­nosed with asthma, a chronic in­flam­ma­tory dis­or­der of the air­ways that causes cough­ing, wheez­ing, and short­ness of breath. It has life-threat­en­ing and life-al­ter­ing con­se­quences, and yet 9 out of 10 pa­tients have poor asthma con­trol. One of the pri­mary rea­sons for in­ad­e­quate man­age­ment is that pa­tients of all ages, from chil­dren to se­niors, aren’t get­ting the ben­e­fit from a full dose of their med­i­ca­tion due to im­proper in­haler tech­nique.

“It’s very sim­ple,” says Dr. An­drew McIvor, a Pro­fes­sor of Medicine at McMaster Univer­sity and a Staff Re­spirol­o­gist at Fire­stone In­sti­tute for Res­pi­ra­tory Health, based in Hamil­ton, ON. “Those with asthma need to make ev­ery puff count to get the medicine they need to feel bet­ter. Most pa­tients can be treated with in­halers, but they must be used cor­rectly.”

Physi­cians may have dif­fi­culty be­ing able to tell if pa­tients are us­ing their in­haler prop­erly.The most com­mon in­haler, a me­tered dose in­haler (MDI), de­liv­ers a pre-mea­sured amount of med­i­ca­tion with a short burst, of­fer­ing re­lief from asthma symp­toms when ei­ther a “rescue” med­i­ca­tion or “con­troller” med­i­ca­tion is used.In order for the med­i­ca­tion to be ef­fec­tive, it must be used prop­erly.

Op­ti­miz­ing in­haler ef­fi­ciency made easy

In­cor­rect us­age of an MDI means the med­i­ca­tion ends up be­ing trapped in the mouth be­fore reach­ing its in­tended des­ti­na­tion — the lungs. When this hap­pens, pa­tients can ex­pe­ri­ence an un­pleas­ant taste in their mouths or de­velop oral thrush (a type of yeast in­fec­tion). There is a de­vice op­tion now clin­i­cally proven to im­prove pa- tient out­comes, as it helps to en­sure those with asthma get the pre­scribed amount of med­i­ca­tion from their MDIs into their lungs more ef­fi­ciently. The AEROCHAMBE­R valved-hold­ing cham­ber helps pa­tients gain greater con­trol of their res­pi­ra­tory symp­toms by de­liv­er­ing the in­tended dose of the med­i­ca­tion to where it is needed in the lungs.

As Dr. McIvor ex­plains, “The cham­ber cap­tures the med­i­ca­tion, like a cloud, so that pa­tients can breathe slowly and take it in. It al­lows pa­tients to take the time to get a breath, then in­hale the right dosage and ex­pe­ri­ence the op­ti­mal ben­e­fits from their med­i­ca­tion.”

Some peo­ple with asthma find that the med­i­ca­tion is dis­pensed too fast, caus­ing them to gasp or gag, in­hibit­ing their abil­ity to take a breath — which can be even more dif­fi­cult if they are hav­ing an asthma at­tack. The AEROCHAMBE­R is avail­able in var­i­ous sizes to specif­i­cally match ev­ery pa­tient’s needs for fit and in­hal­ing abil­ity, and also in­cludes a FLOW-VU in­di­ca­tor en­abling care­givers to see that the med­i­ca­tion is be­ing in­haled.

Bet­ter de­liv­ery of asthma medicine for pa­tients

“There is con­sid­er­able ev­i­dence that valved-hold­ing cham­bers for most pa­tients — es­pe­cially in the very old or pe­di­atric age group — pro­vide bet­ter de­liv­ery of asthma med­i­ca­tions,” says Toronto-based Dr. Ja­son Lee, a Clin­i­cal Im­mu­nol­o­gist and Al­ler­gist and Head of Asthma at The Cana­dian So­ci­ety of Al­lergy and Clin­i­cal Im­munol­ogy. “Us­ing an MDI, even if done cor­rectly, is not as good at en­sur­ing equal in­hala­tion dis­tri­bu­tion as us­ing a cham­ber in con­junc­tion with an MDI, which al­lows for more ‘nor­mal’ breath­ing.An MDI alone re­quires care­ful tim­ing and tech­nique, which must be prac­ticed and per­fected.”

Tiffany Ri­ley, a Toronto mother, has seen the ben­e­fits of a cham­ber de­vice first hand. Her sev­enyear-old son Julius has had asthma since he was two and uses the AEROCHAMBE­R to man­age his symp­toms. “It has al­lowed bet­ter con­trol of my son’s asthma, be­cause when he is us­ing the AEROCHAMBE­R, I can watch the FLOW-VU feed­back in­di­ca­tor and rest as­sured know­ing that he is get­ting each puff when I give it to him,” she says.

By talk­ing to their doc­tor or phar­ma­cist, asthma pa­tients can find out how the AEROCHAMBE­R can play a role in the man­age­ment of their con­di­tion.

This ar­ti­cle was made pos­si­ble with sup­port from Trudell Med­i­cal In­ter­na­tional.

Dr. Ja­son Lee Clin­i­cal Im­mu­nol­o­gist and Al­ler­gist and Sec­tion Head of Asthma at CSACI

Dr. An­drew McIvor Pro­fes­sor of Medicine at McMaster Univer­sity and Staff Re­spirol­o­gist at FIRH

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