Asthma patients are missing vital annual reviews

A new review of GP data conducted by Asthma UK makes for an alarming reading, showing that over a million people suffering with the lung condition are not having vital annual check-ups – important in assessing if asthma medicine is being used in the correct way, to see if lung function has got better or worse, and to check if patient’s asthma inhalers are the most appropriate ones for them.

The new research conducted by Asthma UK discovered that 31% of asthma patients had not received an essential annual review to look at the suitability of their prescribed asthma medicine.

The charity analysed GP statistics from 2012/13 and found that 3,359,612 people in England were scheduled for an asthma review, however 1,025,539 patients had not attended.

Guidance published by the NHS advises all asthma patients to attend their yearly checks as well as keep an asthma action plan and have their inhaler technique looked at. For instance, GPs and asthma nurses need to see if the patient ‘test’ the device first, if the patient shakes the inhaler before using, is breathing out normally, holding the inhaler upright with lips sealed around it, using one actuation only per inhalation, and if the patient is holding their breath for 10 seconds (if possible).

Patients who aren’t using their inhaler correctly may find they are overusing the blue reliever inhaler because they are not sufficiently ingesting the drug to start with. Others find they may be using their relievers far more frequently than previously, and more often than not, these people are not bothering to use the brown preventer inhalers which are massively important in building a long-term improvement.

For example, it can take between 7 to 14 days for the brown preventer to build up its effect, or sometimes as much as six weeks, and will not give immediate relief of symptoms like the blue inhaler offers. The benefits of the brown inhaler build up over time and will decrease the chance of an asthma attack/symptoms occurring by slowly building resistance to triggers.

A recently conducted UK-wide National Review of Asthma Deaths found prescribing mistakes in almost half (47%) of asthma deaths and the quality of care could have been improved in a staggering 83% of the deaths.

The National Review also discovered that only 57% of these patients had received an annual asthma review in the last year of their life. From the other 43% that did have a review, many of these had not even included key components.

Dr Samantha Walker, Deputy Chief Executive of Asthma UK, was speaking on the finding that a quarter of people with asthma in the North of England had not had a review of their condition.

She said: “The fact that over a quarter of people with asthma in the North of England are not getting their medicines checked at their annual review is no doubt contributing to the rising NHS spend on asthma and putting people’s lives at risk. With the worrying scale of prescribing errors identified by the National Review of Asthma Deaths, it’s vital that doctors and nurses do everything they can to follow up with patients to review their medicines, especially as asthma can vary hugely over the year. We’re keen to understand where further improvements can be made to asthma care in the North of England so urge people with asthma to complete our survey www.asthma.org.uk/compareyourcare to find out how their care compares to national standards”.

Asthma drug salbutamol amazingly helped teenager’s paralysis

Could the popular blue reliever inhaler Ventolin Evohaler also be used to relieve…paralysis?!
An 18-year-old suffering with congenital myasthenia, an inherited neuromuscular disorder, took salbutamol and after a week the teen stunned doctors by being able to walk unaided after being wheelchair-bound for seven years.

Jimmy Webster, from Cardiff, had been suffering to such an extent that he had required an oxygen mask to breathe on occasions.

On taking salbutamol, Mr Webster commented: “Within three days I could stand and within a week I could walk.” Next on the agenda for Jimmy is a camping trip. He said: “I wouldn’t have contemplated this last year.”

Salbutamol is a fast-acting medicine used in the treatment of asthma, bronchospasm and is also sometimes used for delaying the delivery in women going through a premature labour. The drug is a beta-2-agonist, and works by relaxing the muscles within air passages of the lungs. This means the airways are kept open and it is much easier to breathe.

However, Jimmy’s experience could pave the way for salbutamol being a main treatment option for more of the estimated 12,000 Brit’s with myasthenia.

Myasthenia can either be inherited, or caused by an autoimmune disorder. This means that the immune system – usually working to protect the body from infections – mistakenly attacks its own tissues.

Those with the autoimmune type of myasthenia have a fault in the transmission of nerve messages from the nerves to the muscles. This results in the muscles not being stimulated correctly and therefore do not tighten (contract) sufficiently, becoming easily tired and weak.

Muscle weakness is a particularly common symptom of the disease, but there are a range of symptoms – which may appear suddenly. Weakness in the eye muscles is often the first symptom, with one or both of the eyelids drooping, and there may also be blurred or double vision.

For some, the muscles around the mouth are affected first, resulting in problems with swallowing (dysphagia), chewing and even talking. Impaired speech and a nasal-sounding voice then usually follow.

Like in Jimmy’s case, some people with the condition can have breathing difficulties, especially during exercise or lying flat, and in some extreme scenarios, myasthenia can cause total paralysis.
Previous studies that shown a similar drug – ephedrine – contained in cold and flu remedies, could occasionally be effective for treating myasthenia. For example, there was another teenage patient who ended up being able to go out jogging and do sit-ups after previously having to rely on crutches to walk.

Therefore, Professor David Beeson at the Weatherall Institute, of Molecular Medicine, Oxford University, wanted to find other drugs that could be just as effective, if not better. Salbutamol was one of the medicines analysed.

Salbutamol may be used in conjunction with other drugs or standalone. Professor Beeson commented: “It is not yet licensed for use in the condition, but clinicians are happy to prescribe it.”
He advised Jimmy to try salbutamol together with pyridostigmine, a treatment he had been on since the age of four.

“I expected I’d get stronger, but had no idea I’d be able to walk again,” says Jimmy. “I still use my wheelchair out and about, but at home I walk around – just getting dressed, washing and cooking, it’s amazing to be able to normal things.”

Professor Beeson is delighted with Jimmy’s progress, adding: “It is incredibly rewarding to see results like this. Over the last couple of years we have seen patients rise from their wheelchairs within months, but Jimmy’s quite exceptional.”

Children given Calpol could be more likely to develop asthma

A major study has found a possible link between paracetamol – the primary ingredient of Calpol medicines – and the risk of children developing asthma.

Calpol is the most popular painkiller in Britain; given to 84% of babies during the first six months of their life, but there are presently no warnings in regards to the possible health risks of the medicine.
In fact, the study, conducted by Spanish scientists, suggests that children who are given Calpol just once each month could be around five times more likely to develop asthma.

Moreover, even those having the medicine just once a year could be up to 70% more at risk claim the researchers behind the study, who have stated their belief that paracetamol may help to explain rising cases of childhood asthma.

Researchers from the University of Da Caruna in northern Spain asked parents of 10,371 children aged 6 to 7, and 10,372 children aged 13 to 14 whether their children were suffering from asthma and if so, the severity of it. Those involved in the study were schoolchildren from six areas in Galicia in Spain, between 2006 and 2007.

In addition, researchers asked the parents how frequently their children were given paracetamol during the previous year and how often during the time they were of infant age.

Children in the younger age group given the medicine at least once a month were apparently over five times more times likely to have asthma and those given it just once a year were found to be approximately 70% more at risk.

However, there are those who have called into question the validity of the study. As the study assessed paracetamol use and asthma symptoms (wheezing) at the same time, it is viable that children with asthma symptoms are simply more likely to be given paracetamol by their parents to help with the symptoms, as opposed to paracetamol directly contributing to the asthma.

Dr Martin Scurr, a GP in London, says it is difficult to draw conclusions from the study and further research needs to be carried out.

“It could be that children with asthma are more likely to get coughs and colds and then are given Calpol by their mothers,” he said. “At the moment Calpol is the best we have – and it’s all we have so there is no reason to stop using it.”

Asthma was assessed by asking parents and children only about episodes of wheezing and as such, may not represent an accurate medical diagnosis of asthma. Also, as the paracetamol usage/frequency was self-reported, it is unlikely to be 100% accurate.

Therefore, it would be wrong to suggest a definite connection between paracetamol use and asthma. As with all medicines, paracetamol should only be given to children if it is required.

The number of children developing asthma in Britain has more than doubled in the last 50 years, with many studies being carried out to find out why, and health experts at loggerheads as to what reasons are causing the increase.

An estimated 1.1 million youngsters in Britain are suffering from the lung condition, and added to 4.3 million adults who have asthma, it causes 1,400 deaths each year in the UK.

Visit the ‘Asthma and Allergies’ area of the Medical Specialists Pharmacy website today for a full list of all the preventer and reliever inhalers we provide for suitable patients.

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. You can undergo a quick and easy confidential online consultation with one of our GMC-registered Doctors and if suitable, they will write you a prescription which is passed to our in-house RPSGB–registered Pharmacists and dispensed to a location of your choice, all within just 24 hours!*

*Allow extra time for overseas deliveries.

Brits still have a poor perception of asthma

Considering there are a staggering 5.4 million asthmatics in Britain, it could be assumed that the majority of us are pretty clued-up on the serious lung condition asthma. Unfortunately, the results of a new survey suggest this could be far from the truth.

Research conducted by supermarket giant Asda showed that whilst 94% acknowledge asthma as a serious health condition, 1 in four respondents could not recognise key symptoms associated with asthma. In fact, 17% incorrectly believed blocked sinuses are a sign of the lung condition.

An additional 15% of those surveyed simply thought feeling dizzy was asthma-related and 13% bizarrely assumed having itchy eyes was somehow a key symptom of asthma. In reality, the primary common symptoms of asthma are having a shortness of breath, wheezing (accompanied by a whistling sound), chest tightness/pain/pressure, coughing (especially at night or early in the morning).
Sufferers usually find their symptoms to be particularly worse at night time, after exposure to cold air, exercise-induced, or brought-on by a reaction to an allergen – similar to hay fever sufferers.

Other wrong assumptions held by Brits include thinking there is a permanent cure for the lifelong condition; incredibly a third of us believe this to be true. Moreover, 15% merely think that asthma is something that only ‘unfit’ people have.

This is clearly untrue though and many are obviously forgetting the countless famous asthma sufferers who have reached the top of their field, such as the multimillionaire and recently retired footballer David Beckham and cyclist Laura Trott, who won gold at the London 2012 Summer Olympic Games in the Team Pursuit and Omnium events.

However, asthma attacks still cause around 1,140 deaths each year and a substantial number of those could have been avoided with more awareness about the condition and how to efficiently control it. Only 37% of Brits have a decent knowledge about asthma medication or can differentiate between the purpose of blue and brown inhalers.

Unfortunately, this perhaps demonstrate a worrying lack of awareness about the fact a person’s asthma can be better controlled with regular and correct utilisation of brown preventer inhalers such as the commonly used Qvar Beclometasone and Easi-Breathe inhalers. Over time, the brown preventers are effective at reducing the need for blue inhalers – which are taken immediately to relieve asthma symptoms and essential in treating asthma attacks.

Visit the ‘Asthma and Allergies’ area of the Medical Specialists Pharmacy website for a full list of all the preventer and reliever inhalers we provide for suitable patients.

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. You can undergo a quick and easy confidential online consultation with one of our GMC-registered Doctors and if suitable, they will write you a prescription which is passed to our in-house RPSGB–registered Pharmacists and dispensed to a location of your choice, all within just 24 hours!*

*Allow extra time for overseas deliveries.

Oldham schoolboy dies from a severe asthma attack

A mother of three from Oldham has called for more awareness to be raised regarding the seriousness of asthma after her 9-year-old son, Joshua, tragically died from an asthma attack earlier this year. In particularly, his mother wants parents to more educated on the difference between the blue reliever inhalers and the brown preventer inhalers, in the hope that other lives can be saved in the future.

Joshua Platt had initially been formally diagnosed with asthma at the age of just one. Despite the early setback, he never let the condition hold him back in life and regularly participated in things such as camping, football, swimming, basketball, judo and enjoyed playing with his younger sisters Demi-Rae, four, and two-year-old Macie.

On 12 February this year, Joshua helped Joanna tidy the house and then went to visit his Grandmother. He had earlier awoken with what Joanna described to the Oldham coroners court as a ‘bit of a sniffle’ and a mild cough, but nothing that majorly concerned her at that point in time.
Joshua arrived back to his home in the Hollinwood area of Oldham at about 7pm and his mum promptly gave him Calpol medicine. After he then started to wheeze, Joshua began rocking backwards and forwards, requested his blue inhaler and asked his mum to rub his back. She says, “He was trying to take deep breaths while trying to talk to me at the same time but was struggling to do both. He was panicking and I was trying to guide him and try to get him to inhale slowly but he just couldn’t.”

Unfortunately his reliever inhaler didn’t have an effect on him and he lost consciousness, leading to Joanna frantically calling for an ambulance to get Joshua to hospital. Despite her best efforts to get him breathing again, Joshua was rushed to Royal Oldham Hospital and tragically, he was pronounced dead at 8.30pm that night.

In what highlights the condition’s severity, the inquest heard that severe attacks could happen to sufferers who did manage their asthma in addition to those who did not. Coroner Simon Nelson recorded a death of natural causes, stating there was unfortunately nothing that could have been done to prevent Joshua’s death. He further called for all parents, teachers and doctors to make sure that asthma sufferers are fully aware of the importance of their preventative medication.

His comments came after Joanna suggested that Joshua had come too accustomed to taking his blue reliever inhalers when his symptoms were showing, and had generally ignored the brown preventer. However, this works over time to reduce the inflammation and mucus in the airways. It could be that Joshua had ignored this type of inhaler as its benefits are not immediately obvious.  They are very important inhalers though and should not be overlooked by asthma sufferers. Gradually over time, the low dose of steroid medicine in the inhaler will have an impact and chest tightness, coughing and wheezing should occur less frequently. Some may even notice that they need to use the reliever inhaler less than before.

Joanna commented, “I think Josh had become laid back about his medication and thought that because he had his inhaler to use if he had an attack, he didn’t need to worry about the other inhaler that would prevent it in the first place. Everyone else was reminding him to take it but he was not aware of how important it was. I think children who have asthma need to be better educated about the importance of all their medication. Teachers and parents should be given more advice. Parents need to be made aware that whether you have got the asthma in control or not that this can still happen. They need to educate their children as well. A lot of people are so laid back about it and think that you can just rely on your blue inhaler but once those tubes close that’s it. To other parents with asthmatic children all I can say is don’t take the inhalers for granted and keep on your child’s back about taking the brown preventer. Josh lived life to the full and his illness never stopped him. He was loved by so many people and had a lot of friends.”

The story of Joshua’s death deeply saddens everybody at Medical Specialists Pharmacy and it shows exactly why we are such strong advocates for the promotion of better asthma awareness to help support the 5.4 million sufferers in the UK, and millions more around the world. Back in August we created an article trying to dispel the unnecessary embarrassment or shame that some asthma sufferers still have with the condition. We have also offered advice and stated some warning signs that asthma sufferers need to be aware of in regards to understanding if their symptoms are under control.

At Medical Specialists we have a wide range of medications to help asthma sufferers. If you are suffering from asthma like symptoms, you should see your doctor immediately for a diagnosis. Your doctor is able to prescribe medication if he feels you have asthma. If you have already been prescribed an inhaler or 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. We now offer both blue (relievers) inhalers such as Ventolin and Salbutamol, and brown (preventers) inhalers such as Qvar Beclomethasone, Qvar Easi-Breathe and Pulvinal Beclomethasone.

There have been occasions when some of our asthma patients have also requested a non-drowsy antihistamine such as Loratadine. Daily use of this medication is particularly helpful for asthma sufferers to reduce season allergies from exposure to pollen, exposure to dust mites, bed mites, pets, etc. or for those who experience severe asthma symptoms after exercise.