Asthma hospital admissions could be prevented with correct inhaler usage

Asthma is a serious, yet sometimes underestimated health problem. Just imagine you are unable to breathe, unable to cry for help, unable to even speak, and paralysed with fear. This is an accurate description of how an asthma attack feels for the majority of the 5.4 million people in the UK who suffer with asthma.

It is believed that around 75% of asthma-related hospital admissions could have been averted through sufficient asthma management and a staggering 90% of deaths from asthma were preventable.

Part of this is through the actual correct/efficient use of asthma medication. According to a pharmaceutical-educational charity partnership, improved inhaler technique may help to drastically reduce the estimated 80,000 plus emergency hospital admissions for asthma, but healthcare professionals should be partly culpable as many are not carrying out proper training to patients for correct inhaler use.

A new study of healthcare professionals published in Thorax suggests that a shocking 70% could not demonstrate the right metered dose inhaler technique to asthma patients, and around half of the patients themselves were unable to use the correct technique with their inhaler.

It might be alarming to know that poor use of an inhaler can result it as little as 5% of the drug being transmitted to where it is urgently required – the lungs. Therefore, symptoms are not controlled and the risk of an emergency hospital admission suddenly increases a significant amount.

The good news is that Napp Pharmaceuticals have joined forces with the charity Education for Health to provide inhaler technique training to any CCGs and NHS providers looking to boost their respiratory services and undoubtedly cut asthma hospital admissions in the process.

Community pharmacists from Cambridgeshire and Peterborough CCG and Pharmicus in Gateshead will be involved with pilot programmes after the success of a similar inhaler technique programmed on the Isle of Wight, whereby trained multidisciplinary teams including GPs and respiratory nurses, led to a 50% drop in asthma emergency admissions and a 75% decrease in associated deaths.

Monica Fletcher, CEO of Education for Health said: “This training will enable healthcare professionals to provide the most accurate and up to date inhaler technique to their patients. There is no reason why, with the correct treatment and management, that the majority of people with asthma shouldn’t be able to live symptom free.”

Dr Joe diCapite, inhaler technique project manager at Napp said “We know that several CCGs recognise inhaler technique as an issue for their patients. Napp and Education for Health want to work in partnership with CCGs to create inhaler technique programmes that address the specific training needs of their healthcare professionals, with a shared aim of delivering better patient outcomes.”

If you have asthma and would like more information on using your inhalers, Asthma UK have provided helpful videos on how to correctly different asthma inhalers such as metered dose inhalers, easi-breathe inhalers, an autohaler and various other types of inhalers.

This Morning presenter Matt Johnson hasn’t let asthma beat him

Welsh Daytime TV presenter Matt Johnson has highlighted the seriousness of asthma and the importance of using asthma medicine after speaking to Wales Online, describing how he almost collapsed ‘in the middle of nowhere’ whilst out running.

“I had to stop because my chest was so, so tight,” Matt revealed. “I was halfway through my run, in the middle of nowhere and I really panicked. The more I panicked, the more it got worse. In the end I managed to calm down a bit and eventually it got better.”

However, it is not only physical exertion that triggers the 30-year-olds asthma symptoms; the handsome presenter from Caerphilly even admits that he sometimes struggles when on screen to millions around the UK.

Recently, a comical comment from fellow presenter Eamonn Holmes particularly left the Welshman gasping for air. Matt commented: “Weirdly, when I laugh really hard I get a very tight chest. The other day Eamonn Holmes made me laugh on the This Morning set because I tried to get him to join a nudist beach club and he gave me a very good reason why he shouldn’t. I laughed out loud and my chest got very tight.”

Interestingly, and a subject Medical Specialists Pharmacy have previously touched upon, Matt used to be almost embarrassed to get out his inhalers to use and says the condition was ‘uncool’ in school. His experience whilst out running and without his medication has left him taking his condition a lot more seriously however.

He says: “I can happily take my inhaler anywhere in front of anyone and always have a puff before a live broadcast just in case. I keep on top of my asthma now because the thought of having a severe attack is terrifying.”

Asthma is a long-term respiratory disorder, where the air passages within the lungs unexpectedly become inflamed, narrowed, and swollen. This then prevents airflow into and out of the lungs. Attacks occur often in response to an allergen, cold air, exercise, or emotional stress.

It is thought that there are 5.4 million people in the UK currently receiving treatment for asthma. This equates to 8.8% of the total population (62 million estimated in 2010). In addition, it affects a staggering 300 million people worldwide.

From this total, there are a huge number of celebrity figures who have asthma and in recent times, many have spoken out about their experiences battling the condition in order to raise awareness.  In February, Olympic hero Laura Trott gave a detailed account on her asthma and there are many other celebrities with asthma such as David Beckham, Paul Scholes, Paula Radcliffe, Bradley Wiggins and Rebecca Adlington. All of these famous faces did not let asthma overcome them, and with proper management of their symptoms and making sure to use their inhalers, all achieved their goals without letting asthma hold them back.

You don’t need to take our word for it though, Matt continued: “When I grew up asthma always seemed like something that was a geeky, uncool thing to have. So if me running around the place shows people that I’ve got asthma but life goes on, then that’s wonderful. I remember at school people thought it was an uncool thing to have. Some kids suffer with it really badly but it’s not much fun to have it made into a joke. Some people are so disabled by their asthma, physically but mentally. Many people think, oh I can’t take part in exercise – I’ve got asthma. But you only have to look at someone like Bradley Wiggins or Laura Trott who have asthma but went onto win Olympic gold medals at London 2012. When you think of people with asthma like me from daytime TV, world class athletes and someone like One Direction’s Harry Styles , who was seen taking his pump at the side of the stage and then carrying on with a huge concert, then surely that’s inspirational enough.”

The presenter is due to host charity Asthma UK’s ‘Breathtaking Ball’ in London on Friday to raise awareness and funds for asthma.

Genetic testing could lead to tailored asthma treatment

Scientists from Dundee University claim that a relatively simple and inexpensive ‘spit test’ could pave the way for creating bespoke asthma treatment for children suffering with the lung condition if a specific genetic mutation is detected and thus practically rendering their current treatment almost useless.

The Dundee University scientists collaborated with colleagues at Brighton University to analyse a total of 62 children who all had poorly controlled asthma and in many cases it was determined that their prescribed medication could be the source of the problem.

In particularly, a common culprit could be the inhaled ‘salmeterol’, found in both seretide and servent inhalers. Salmeterol is used by children with severe asthma that cannot be controlled with just their inhaled steroid medication such as the blue inhaler Ventolin – a popular inhaler prescribed to all children after they are formally diagnosed as having asthma.

The scientists believe that genetic code is the reason why some children fail to respond to the salmeterol. The drug is known as a ‘bronchodilator’ beta-2 agonist meaning it acts at stimulating beta-2 receptors on the muscle cells that line the airways. This results in these muscle cells being able to relax and open the airways.

Unfortunately however, an estimated one in seven people have a genetic mutation – the arginine-16 genotype of the beta-2 receptor- that causes their receptors to have a slightly altered shape than normal and the salmeterol does not acknowledge this difference.

All 62 children involved in the study had this genetic mutation and all had required periods of time off school, had hospital treatment or had visited a GP out of hours due to their asthma flaring up. During the study, the authors allowed the children to use their basic inhaler to control symptoms. In addition though, half were chosen at random to receive salmeterol and the other half were administered the anti-inflammatory medicine montelukast, used to prevent children from experiencing an asthma attack.

Within just three months it was discovered that those taking montelukast had significantly less coughing and wheezing, less likely to experience any deterioration of their asthma symptoms, as well as more likely to use their reliever inhaler less frequently than before.

At the beginning of the study, researchers calculated that 36% of the children had to use their reliever inhaler on a daily basis. After the year-long study had come to a conclusion, the total number of children using this inhaler every day had been slashed by half in the montelukast group. Interestingly, this trend was not seen within the salmeterol group.

Professor Somnath Mukhopadhyay said: “For almost every clinical outcome we were looking at we found that salmeterol either wasn’t working or was working very poorly. Montelukast was very much better. We’ve shown for the first time that personalised medicine can work in the field of childhood asthma.”

Prof Mukhopadhyay says the simple test would cost around £15 if it were to ever be introduced into GP surgeries, adding that it is unacceptable to prescribe drugs to children that are ineffective. He continued: “It’s a common disease affecting a million children in this country.  A common medicine is probably not working in a significant proportion of the population. I think we need to get some guidance from lead charities and from the Department of Health.”

Professor Stephen Holgate, MRC clinical professor of immunopharmacology at Southampton University, commented on the results of the study and said: “While genetic changes that determine bronchodilator responses in asthma have been known for some time, this is a wonderful example of stratified or personalised medicine working its way into practice. While still a small trial, the results in the asthmatic children’s response to the two treatments across a number of asthma outcomes are impressive.”

New drug Tudorza Pressair is given FDA backing for the treatment of COPD

This week has seen yet another new drug been given a clearance by The Food and Drug Administration (FDA), following the recent seal of approval for two new weight loss medications, Qsymia and Belviq, as we reported last week.

On this occasion, the drug to be given an authorisation for public use is a twice-daily inhaled medication named ‘Tudorza Pressair’, which is used to help treat symptoms of bronchospasm. This is associated with chronic obstructive pulmonary disease (COPD), aka ‘smoker’s cough’.

COPD is a term used for numerous conditions, including chronic bronchitis and emphysema, and is similar in certain characteristics to asthma. Bronchitis and emphysema are commonly co-existing diseases of the lungs in which the airways become narrowed, thus making it difficult for air to get in or out of the lungs.  Obvious symptoms can include chronic cough, tightness in the chest, and excessive phlegm.

Asthma and COPD can exist in the same person. However, in contrast to asthma, the inflammation of the lungs with COPD is not triggered by allergies and does not respond well to anti-inflammatory medication. In 2005, there were over 3 million deaths worldwide linked to COPD, with the main cause being the damaging effects of cigarette smoking.

On Tuesday, Spain’s biggest pharmaceutical company Almirall, and US drugmaker Forest Laboratories, confirmed they had been given the coveted FDA green light for Tudorza Pressair. This followed a slight hiccup back in March when the FDA demanded that it wanted a three-month extended time period to analyse the review data supporting the New Drug Application for aclidinium bromide (the powder ingredient within Tudorza Pressair).

Despite entering into an already competitive market where highly popular effective medications such as Ventolin can alleviate COPD symptoms, analysts at Sanford Bernstein say that sales of the Forest/Almirall drug could hit $164 million by 2015.

A spokesperson at Forest commented saying, “As the first long-acting inhaled anticholinergic agent approved in over 8 years for COPD, Tudorza will be an important treatment option.”
Curtis Rosebraugh, MD, Office of Drug Evaluation II, FDA’s Center for Drug Evaluation and Research, Rockville, Maryland, said, “COPD is a serious disease that gets worse over time. The availability of long-term maintenance drugs for COPD provides additional treatment options for the millions of people who suffer with this debilitating disease.”

However, the FDA have also warned that the drug may cause some serious side effects such as paradoxical bronchospasm, new or worsened urinary retention, or new or worsened pressure in the eyes (known as acute narrow-angle glaucoma). The FDA also says the medication is not fit to be used as a rescue therapy to help aid sudden breathing difficulties such as acute bronchospasm.

When Medical Specialists Pharmacy know more about this and other medications that are being approved by the FDA to help with asthma or COPD, we will update our patients immediately. In the meantime, Medical Specialists Pharmacy provides a huge range of medications to help asthma sufferers, all at great prices. If you have already been prescribed an inhaler, have lost your inhaler, or run out and cannot get a prescription immediately, we are able to supply you an inhaler to help your asthma symptoms.   After undergoing a private and confidential online consultation with one of our Doctors, if you are suitable they will then write you a prescription which is passed to our in-house Pharmacists and dispensed to a location of your choice. This is all done discretely and within just 24 hours. We offer both blue (relievers) inhalers such as Ventolin and Salbutamol, and brown (preventers) inhalers such as Qvar Beclomethasone, Qvar Easi-Breathe, and Pulvinal Beclomethasone.

Asthma inhaler sensor given clearance by FDA

Asthma sufferers all around the world may soon have a revolutionary device in their possession after the US Food and Drug Administration (FDA) granted a 510(k) clearance on Tuesday to a Madison based company to start rolling out its asthma inhaler sensor. This kind of clearance means it can be marketed based on the fact there is an existing comparable product in the market already.

Asthmapolis have announced they received the federal clearance required to start offering the sensors to the public, together with mobile and web application software. The sensors are named ‘the Spiroscout’, and will only be available on prescription.

The sensor can be attached to most reliever inhalers such as the widely used Ventolin, and preventive inhalers such as Qvar’s Beclometasone and Easi-Breathe inhalers. It works by transmitting data to the person’s smartphone upon each discharge of their inhaler and satellites can then pinpoint the user’s location and pass all information back to the company’s server.

Asthmapolis boast that their new device is ‘small and lightweight’ and ‘easy to mount securely on the end of most inhalers’. Some advantages to asthmatics will be the generation of weekly reports, providing information on how many times they have used their inhalers, locations of asthma attacks, and they can even receive text messages that remind them to use their asthma medications.
The chances are that not every single person who suffers from asthma or chronic pulmonary obstructive disease will also own a smartphone, so the makers have devised a plan to cater for this. Users can connect their sensor to an access point called ‘2net Hub’, created by the wireless health network company Qualcomm Life.

Inger Couture, Chief Regulatory Officer of Asthmapolis, commented on the new device via a written statement and said, “We are thrilled to have achieved this important milestone to support our mission of providing tools to help patients and their healthcare providers better understand and control their asthma symptoms. Despite all we know about asthma and how to treat it, the majority of patients still do not have the disease under control, and traditional approaches to self-management have been time-consuming and complicated. The Asthmapolis technology makes it much easier to track symptoms and use of metered dose inhalers, allowing patients, their families and their doctors to gain a valuable new perspective on the disease.”

The proportion of asthmatic individuals in the United States increased by nearly 15% from 2001 to 2010, at which point it was thought there were 25.7 million people were affected. So clearly the device will benefit many people. Also in the UK there are approximately 5.4 million people currently receiving treatment for asthma. The lung condition is a worldwide problem, and can be deadly if you are not keeping track of your symptoms and attacks through the use of an asthma diary, or do not have sufficient supplies of your asthma inhalers.

At Medical Specialists Pharmacy we offer a wide range of medications to help asthma sufferers, all at great prices. If you have already been prescribed an inhaler, have lost your inhaler, or run out and cannot get a prescription immediately, we are able to supply you an inhaler to help your asthma symptoms.   After undergoing a private and confidential online consultation with one of our Doctors, if you are suitable they will then write you a prescription which is passed to our in-house Pharmacists and dispensed to a location of your choice. This is all done discretely and within just 24 hours. We offer both blue (relievers) inhalers such as Ventolin and Salbutamol, and brown (preventers) inhalers such as Qvar Beclomethasone, Qvar Easi-Breathe, and Pulvinal Beclomethasone.

Hereford teen dies from suspected asthma attack

An 18-year old beauty student from Hereford has tragically passed away after speaking to her mother on the phone and complaining she was short of breath. Bianca Hart was enjoying a socialising drink with friends in Hereford on 27 June to celebrate the end of her exams at Hereford College of Beauty before her asthma symptoms began to develop. After phoning her mother to say ‘I can’t breathe’, she was immediately rushed to the County Hospital in the early hours of Thursday 28 June.

Bianca lost consciousness inside the hospital after suffering a huge asthma attack and whilst awaiting an assessment from doctors. Paramedics then tried their best to save her but unfortunately she died a few hours later. Police have spoken to immediately dispel any notion that her drink may have been spiked. Bianca’s sister released a statement and paid tribute to her sister, saying, “Bianca lived life to the full, loved to be around her friends and socialising around the town. She was a very caring person, trustworthy, lively, beautiful, angelic by nature, fashionable and a confident person.”

Bianca is the third person to die from a suspected asthma attack in Herefordshire in the last two months, following the death of a 14-year old Ross-on-Wye schoolgirl Lauren Hughes and 48-year old Linda Robinson.

These deaths have stressed just how serious asthma can be if not properly treated and managed. Attacks can occur at any time but certain things can trigger an attack such as:

. Smoke from cigarettes. We would advise you stop smoking immediately if you smoke and have asthma, or avoid inhaling the smoke from those around you.
. Pollen from trees and grass.
. Paint fumes.
. House dust mites.
. Changes in air temperature. For example going from a warm room into cold air outside can sometimes trigger an attack.
. Some asthmatics experience an asthma attack during exercise and may need to use their reliever inhaler such as Ventolin prior to beginning the exercise. You can obtain this from Medical Specialists Pharmacy cheaper than on the NHS.

The problems of Asthma are a global issue that Medical Specialists are determined to do something about by offering patients a wide range of asthma reliever and preventer inhalers to best suit your needs. Indeed across the Atlantic, North America is currently experiencing soaring temperatures in the grip of a torturing heat wave. The heat will affect everybody, but those with asthma a lot more.

Lafayette asthma and allergy physician Dr. Ketan Sheth spoke last month about how the heat will have impact on asthmatics and said, “Hot weather increases a lot of pollution that is outside so air pollution is going to cause people with asthma to have trouble and just the heat and the humidity itself is really going to trigger problems.” Americans suffering from asthma have been warned to take the following precautions to stay safe during the heat wave:

. Stay indoors with the windows close. This can help to avoid smoke, dirt and other things that could trigger an attack.
. Keep hydrated.
. Keep up to date with the weather forecast.
. Limit outdoor activity if possible.
. Be careful using fans – These can blow allergens around the air.
. Finally, plan what action to take in case of an attack. Use your asthma medications often and always have rescue medication in your possession.