Asthma control could halve AE visits

PROPER ASTHMA control could cut the number of sufferers attending accident and emergency departments by half every year, it has been claimed.

The Asthma Society of Ireland believes that Ireland could learn from a highly successful programme which was introduced in Finland in the 1990s.

The 10-year national asthma programme in Finland saw AE admissions cut by 54 per cent and the average costs of treating asthmatics fell by a third.

There are about 470,000 asthma sufferers in the Republic - the fourth-highest prevalence of asthma in the world.

Each year about 20,000 sufferers end up in accident and emergency departments.

Controlling Your Asthma - Facts to Take Your Breath, an information evening held at the Royal College of Physicians in Kildare Street last week, attracted more than 200 people seeking information on how to control the disease.

The meeting featured question and answer sessions from experts in the field and was chaired by former Ireland rugby international Denis Hickie who had a successful sporting career despite being an asthmatic.

The Asthma Society of Ireland's chief executive, Dr Jean Holohan, said the question and answer session, which lasted over an hour, illustrated the need for a proper asthma awareness programme in Ireland.

"We have seen in the case of Finland that early diagnosis, active management, patient education and guided self-management can produce phenomenal results.

"The questions that were being asked are the ones that come up on our helpline time after time.

"They highlight the importance of access to good quality information, yet in this country people accept a less-than-optimal level of asthma control," Dr Holohan said.

Prof Stephen Lane, a consultant respirator physician at the Adelaide and Meath Hospital Tallaght, told the meeting that the causes of asthma were a "medical mystery" which involved inflammation of the bronchial tubes, leading to breathing difficulties.

He said many problems relating to asthma were caused by patients thinking that they did not need to take appropriate medication when they were feeling well.

"Asthma is a condition unlike blood pressure which is driven by symptoms. If you had blood pressure, you would be willing to take a tablet for 30 years to stop you getting a stroke down the line.

"Because asthma is a symptom-driven condition, as soon as the symptoms are gone, the people think they are better, but the symptoms are the tip of the iceberg or the tip of a pyramid. We do know that this leads to the perpetuation of the asthma syndrome."

Asthma sufferers at the meeting were advised to continue taking preventative drugs, which are mild steroids, on a daily basis even when they were feeling well.

Dr Holohan also said that an expensive drug available to the worst asthmatic sufferers should be more widely available.

Only about 60 severe asthma suffers currently take Omalizumab (Xolair), a drug which costs about €12,000 a year to administer to patients.

Dr Holohan estimates that 400 of the most severe asthmatic sufferers could benefit from Xolair nationwide.

Currently, it is available only through the hospital budgets, but the asthma society wants Xolair to be made available through the high-tech drugs scheme.