03rd, May 2022, Anand: 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 underdiagnosis and undertreatment 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 to by lay publicas‘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, Dr. Rajiv Paliwal (Senior Pulmonologist) Zydus Hospitals, Anand stressed the importance of addressing the social stigma toward 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% of asthmatic patients call their disease asthma. The 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. Rajiv Paliwal (Senior Pulmonologist) Zydus Hospitals, Anand 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 the 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 them get the right information and diagnosis for their symptoms and start with the right treatment early on. Timely diagnosis is very important to managing asthma. Understand your asthma symptoms and consult your doctor.