Asthma Treatment Today
Asthma sufferers in the bush worse off
An Australian Institute of Health and Welfare report has found a stark contrast between the quality of care provided to asthma sufferers in poor and remote areas compared with patients in the city.
The report found asthma sufferers in low socio-economic and remote areas are more likely to end up in hospital within 28 days of an attack.
Overall the number of people who end up in hospital for asthma has dropped over the past decade, but the study shows the number of people who are readmitted within a month of treatment remains stable.
Professor Guy Marks from the Australian Centre for Asthma Monitoring led the study and says children under the age of five or adults over 35 are more likely to be admitted to hospital for treatment than older children and young adults.
“About 4.5 per cent of people who are admitted to hospital are re-admitted within 28 days,” he said.
“Between 1996-97 and 2004-05 there were 335,461 admissions to hospital for asthma among 287,924 individuals. Among these individuals around 13,551, that is 4.71 per cent, were readmitted to hospital for asthma within 28 days.”
The study has also found the risk of readmission to hospital was higher in some areas compared with others.
Professor Marks says people in disadvantaged areas and those that live in remote parts of the country are more likely to be readmitted within 28 days compared to those living in major cities.
He says the study suggests there is a gap in the quality of care between remote and urban areas.
But he says the study does not indicate where the problem with the quality of care arises.
“It is important to recognise that although this is about admissions, it is not necessarily saying it is the quality of care in hospital that is the problem,” he said.
“It is really across the continuum of care from being in hospital to primary care to specialist care in the community and also to communication among those very sectors of care because management of asthma really involves a continuum of care that involves GPs, specialists and hospital care and communication amongst those people.”
Michelle Goldman from the Asthma Foundation of New South Wales says GPs, pharmacists, the Asthma Foundation and hospitals need to work together to make sure people who are leaving the emergency department are put in touch with the right services.
Ms Goldman says the Asthma Foundation provides access to a wide variety of information and support services for asthma sufferers. She says she is not surprised by the study.
“It makes sense that admissions are higher in lower socio-economic areas,” she said.
“Basically people in those areas don’t have access to the services to help them manage their asthma or they simply can’t afford them, so it is how can we provide services that are free and that will help people to better understand and manage their asthma in the vacuum of physical services.”
Mercy specialist offers allergy-coping advice
Despite some chilly days in March, spring is already in air, and allergy season is now – and progressing.
“Even though it looks dreary outside, tree pollen typically begins to emerge in February, that’s why we tell our patients to start their allergy medications early,” said Sarah Samimi Field, MD, a specialist in allergy and immunology. “If you’re allergic to pollens from grasses, trees and weeds, your symptoms could worsen as the season progresses, and pollen is stubborn. Just as you see it on your car, windows and patio furniture, it is likely on you as well, and it gets tracked into your home.”
Typical seasonal allergy symptoms include itchy nose and eyes, sneezing, stuffy nose and runny nose. People with asthma may experience increased coughing or wheezing. How people react depends on how severe their allergies are.
Dr. Field recommends that people with seasonal allergies run the air conditioning, keep their windows closed at home, work and in the car, change their home air filter frequently and shower before bed to wash pollens away. She also recommends using over-the-counter medications to ease symptoms rather than avoid outdoor activities.
“The ultimate goal is for people with seasonal allergies to go outside and enjoy the weather and everything the outdoors has to offer,” Dr. Field said. “There is no cure for allergies, but with the right treatment, you can go outside and have fun.”
She added, “There are a lot of great over-the-counter medications available, but they don’t work for everyone. If they don’t work for you, or you’re having increased sinus infections, or your asthma symptoms seem to be out of control, then it’s time to talk to your doctor or see a specialist who can offer treatments with the most benefits and the least side effects.”
Dr. Field is board certified in Allergy and Clinical Immunology, she sees both children and adults. Her office is located in Suite 208 in the St. John’s Mercy Medical Building, 851 E. Fifth Street in Washington. For more information or to schedule an appointment, call 636-432-0111.
New Asthma Treatment Offers Relief
A new treatment could bring relief for those with severe asthma symptoms. It is called bronchial thermoplasty, and it is being performed by doctors at Mount Carmel Hospital in Columbus.
“This is the first novel treatment for asthma that has come on board in years,” said Dr. Roy St. John, of Pulmonary and Critical Care at Mount Carmel West Hospital. Dr. St. John is the first doctor in Columbus performing this new procedure, which was recently approved by the Food and Drug Administration.
Asthma affects 23 million people including nearly 7 million children in the United States, according to the Centers for Disease Control and Prevention. Symptoms of asthma include coughing, wheezing, shortness of breath, and pressure or tightness in the chest. It can be both painful and frightening, and often leads to a series of medications.
4 Your Health got an inside look at bronchial thermoplasty, as it was performed on Sami Snokes, a Columbus mother of four who has suffered from asthma for more than ten years.
“It gets scary sometimes. Your chest tightens up. You feel like you can’t breathe and you panic,” said Snokes who is on numerous medications to treat her asthma symptoms. Snokes is trying bronchial thermoplasty with hopes that she can reduce her medication and emergency room visits.
Bronchial thermoplasty works by applying low level, radiofrequency heat to the smooth muscle in the lungs that thickens in asthma patients and contracts causing their symptoms. Dr. St. John uses a specially designed catheter to go deep into Snoke’s airway. On the end of the catheter, is a small tool that does all the work.
“You can see on the end of the catheter it looks like a little whisk or basket and then on the tips of those are where the heat gets delivered,” said Dr. St. John as he showed NBC4 medical reporter Ellie Merritt how the device works.
The heat that is applied to the muscle helps to clear the airway, making it easier to breathe. The procedure takes about an hour, as Dr. St. John works his way through the airway with the catheter. It takes three separate treatments to complete.
Dr. St. John said bronchial thermoplasty is only for patients with severe asthma symptoms. He said the results are dramatic, with studies showing an 84 percent reduction in emergency room visits and some patients can reduce or even eliminate their medications. However, since this treatment is so new, Dr. St. John said insurance does not cover the procedure, which costs approximately $20,000.