Breath-activated asthma inhalers could save more lives than traditional devices, according to scientists.
The study compared levels of asthma control and the need for doctors’ visits for patients using the different devices by examining medical records of close to 900,000 asthma patients in the UK.
Researchers found that both children and adults using the breath-actuated device had better control of their condition than those using traditional 'press and breathe' inhalers, which are more commonly prescribed by doctors.
There are currently more than 5 million people in the UK living with asthma.
There are a wide variety of inhaler devices available for the treatment of asthma and using the correct device is crucial, according to researchers. In the study, patients using the breath-actuated device had less use of medication for asthma symptoms and fewer courses of steroids and antibiotics.
In the UK, more than 5 million people suffer from asthma. Currently, guidelines indicate no difference in the cost-effectiveness of using different inhalers in the treatment of asthma.
BBC News February 27, 2003
This study only appeared in the UK and will likely be largely ignored in the United States. However, it does bring up important, potentially life saving information for the 20 million people who struggle with asthma in the United States.
Most inhalers used are the traditional press and breath inhalers. While these are the easiest to use they are also the easiest to use incorrectly. If one is not very skilled in using them the drug will not reach the lungs. When a person is in the middle of an asthma attack it is possible that the attack could be fatal simply due to not understanding how to coordinate the breathing with the release of the drug from the inhaler.
Unfortunately, 5,000 people die from asthma in the United States every year, and the above factor is a major consideration in many of the deaths. While the breath activated devices are much harder to learn how to use initially, once they are mastered they provide superior drug administration.
Breath-activated inhalers are similar to aerosol inhalers, but their design helps to overcome problems of coordination. As you breathe in through the mouthpiece, the inhaler releases your medication automatically.
To get the full benefit from these devices you need to make sure you hold your breath for about 10 seconds (or as long as is comfortable) after taking the medication. For this reason, breath-activated inhalers are sometimes not recommended for younger children. Breath-activated inhalers are not designed for use with a spacer.
If you are going to use a traditional aerosol inhaler, the following are simple instructions to help you confirm you are getting the drug in your lungs.
1. Sit up straight or stand up when taking your inhaler. Lift your chin up to open the airways.
2. Remove the protective mouthpiece and shake the inhaler (to mix the medication with the liquid propellant).
3. Spray test your inhaler if you have not used it for a week or more.
4. Breathe out gently as far as you comfortably can.
5. Place the mouthpiece in your mouth between your teeth and close your lips firmly around it, but do not bite it.
6. Breathe in slowly and deeply through the mouthpiece and press down on the canister inside the inhaler at the same time. This releases one puff of medication. It is important you continue to breathe in after releasing the puff.
7. Take the inhaler out of your mouth and hold your breath for 10 seconds (or as long as is comfortable) then breathe out slowly.
8. If you need to take more than one puff, wait about 30 seconds, shake your inhaler again and start from step 4.
9. Ideally aerosol inhalers should be used with a spacer to increase their effectiveness and the instructions are as follows:
1. Remove the protective mouthpiece and shake your inhaler as usual. Insert it into the spacer.
2. Place the mouthpiece of the spacer in your mouth.
3. Squirt one puff of your inhaler into the spacer and breathe in deeply through the mouthpiece.
4. Hold your breath for 10 seconds (or as long as is comfortable) then breathe out slowly.
5. Breathe in deeply again through the mouthpiece. It is best to take at least two deep held breaths for each puff of your inhaler, but if this is difficult five or six slow breaths in and out will do (this is sometimes called 'tidal breathing').
6. You should only put one puff of your inhaler into the spacer at a time. If you put in more than one puff, the droplets of spray stick together and coat the sides of the spacer so you actually get less medicine. If you require another dose of medication, wait 30 seconds, shake your inhaler again and start from step 2.
However, whichever inhaler you use, it is relying on the Band-Aid drug model. As I said in the last issue:
With respect to asthma, simple changes can produce very profound improvements in your ability to breathe. Following the nutrition plan is one of the first steps--avoiding sugar, fruit juices, most grains and pasteurized dairy products is nearly always helpful. Replacing commercial milk with raw milk from grass-fed cows is also usually well tolerated and highly health promoting.
Making certain that enough long-chain omega-3 fats (DHA and EPA) from fish oils are included in your diet is also helpful. I find Carlson fish oil and cod liver oil to be one of the most superior brands available as it conforms to the strictest guidelines for purity and freshness. It is available in most health food stores, and Carlson fish oil and cod liver oil are also available in our online store.
For more severe and resistant cases of asthma, allergy skin testing can be appropriate. Traditional allergy treatments are one of medicine’s safer and better approaches, however it has great room for improvement. My experience with conventional allergy testing, whether done through the blood (RAST) or skin is that only 20 percent to 30 percent of patients do exceptionally well with it. It is also highly inconvenient, as patients need to go to the doctor’s office every week for months or years. It clearly does not work for the majority of patients.
For the last 10 years, I have been using a much improved version of this testing, which is taught by the American Academy of Environmental Medicine, called Provocation Neutralization (PN). The success rate for this approach is in the 80 percent to 90 percent range and patients can receive their treatment at home.
Both systems are time consuming and expensive though. A course of PN treatment and testing can run about $1,000 to $2,000. However, this is less than many patients are already spending on one year’s worth of allergy medicines, and it is a long-term solution that will, in most cases, provide a permanent treatment. There are also virtually no side effects with the treatment, unlike with conventional drugs.
It is important to remember that the allergy desensitization program is in addition to, not a replacement for, a comprehensive nutritional approach.
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