Breathing freely – how to live a good day with asthmaHealth | 18/04/2023
For many people with asthma a good day for them is one which looks like anyone else’s. The ability to breathe normally, to go for a run, and to not worry about asthma.
Living with asthma can be challenging and sometimes even unpredictable, and experiences vary from one person to another. But whether you are based in Tunbridge Wells. United Kingdom (UK) or Tampere, Finland, the reality of the condition can feel the same. We are united through relatable experiences.
A day without symptoms can be a great day
Darren Glen, 53, is a legal executive working near the borders of Scotland, (UK). He moved there ten years ago from the south coast and since then, has not had an asthma attack.
‘For me, a good day looks like anybody else’s completely normal day,’ he explains. ‘I can breathe without wheezing, go to the gym, and just live my day. The problem is, because I have asthma, this could change in a moment like a light switch.’
Having previously experienced asthma attacks which required hospitalisation he is grateful for the upward turn in his condition. But he does not truly know why his symptoms have decreased. He believes it is down to a combination of factors. He now has a sympathetic and understanding doctor, who listened to his medical history and answered his queries concerning medication.
Better air quality, he believes, also played a role, as well as a reduction in life stresses.
Darren is aware that he always needs to carry medication wherever he goes. He said: ‘Although I have not had an attack in a long time, you always need your ‘kit’. I know there have been improvements, but anything which makes taking medication easier is another step towards a good day.’
Speaking with other people living with the same condition, he said that complacency is understandable but needs to be avoided. ‘Self-discipline is so important. You always need to take your medication regularly and keep on top of maintenance, even if you have not had an attack. That can be hard to maintain when you have no symptoms, but I’ve learnt it is vital to help me live my life the way I want to.’
Globally 262 million people1 live with asthma. The UK has some of the highest rates of asthma in the world. Around 5.4 million people have asthma in the UK2 out of 67 million. Asthma is not a curable disease but with consistent treatment, symptoms can be managed, and the frequency of attacks reduced.
People living with asthma may accept certain limitations their condition brings. Ideally, like Darren, they would want to spend more time with their healthcare professional to discuss treatment plans and understand what is prescribed and why. They want to live every day as a ‘good day’.
National asthma and allergy programmes in Finland have shown how proactive management and lessening or preventing the causes which exacerbate asthma, help people live a normal life3,4 In Finland the prevalence of asthma in adults is approximately 11%, so in the same level as elsewhere in Europe. However, asthmatics have significantly fewer symptoms than 20 years ago and increase in asthma prevalence is levelling off in Finnish adults5.
So, what can the UK and other countries learn about successful changes in Finland? Asthma may be on the increase worldwide, but we know that improved management, increased understanding among both asthmatics and doctors, access to essential medicines and education have been essential in reducing morbidity and mortality6.
Asthma education and self-management
In Finland, education has been a strong focus for health professionals, and asthmatics are encouraged to take advantage of guidance offered and be aware of how to manage their condition effectively. This includes training on how to use inhalers correctly and how to recognise and respond to symptoms if they get worse. This may involve regular appointments with a nurse or doctor to review and adjust treatment plans.
In some regions, in the UK, the offer of self-management education is still insufficient and the uptake from people is lacking7. There are simple reasons to explain why someone may choose not to attend training; the cost of travel or time may be beyond what they can afford. A lack of awareness that they need this help can also explain absences. And similar trends may be true of clinicians and doctors experiencing stretched resources.
In a survey of 15 general practices in Scotland, doctors were tested on their knowledge of guidelines relating to asthma 7. 98.4% were aware of the recommendation to offer education in self-management and written action plans for any asthma patient on their books. However, in practice, only 12.8% of practitioners provided such a plan.
How does this help someone in the UK, or living outside the Nordics, to be better able to manage their condition? It helps to understand that rather than location, the answers appear to be in having a holistic attitude to maximise all options for a healthy life, regardless of location.
Self-education, nutrition, healthier lifestyle, and true understanding of an individual’s asthma all play a relevant part.
It is understood that asthmatics reported significantly fewer symptoms in 2016 compared with previous years in Finland5. Several factors play a role in this including both improvement in medication and diagnostics. But empowering asthmatics and committing to regular check-ups seems to be a crucial link in the successful approach in Finland. This is why a multi-faceted approach is advocated. As well as a shift in medication prescribed, healthier lifestyles are increasingly adopted.
What can happen next?
The results in Finland over the past 20 years should be encouraging to everyone, no matter the environment in which they live. The right combination of medication, the desire to remain vigilant, to self-manage, and to be educated all help in achieving good days.
Education is essential in helping people feel empowered. How else will they be able to take steps in making important lifestyle changes including stopping smoking and being more active?
They need to know what questions to ask, and how to make these changes. A bond of trust can be developed between a person and their doctor through regular communication. A person needs guidance on why they need to maintain a regular treatment regimen; what methods to try to give up smoking, to avoid passive smoke and what it means to maintain an active lifestyle.
Simple steps for asthmatics to make every day a good day
Having in place sensible approaches to reducing the likelihood of an attack, makes sense, as Darren has found. Avoiding known triggers such as smoke, gases, dust and fumes will all help. Without maintaining the right medical regime, uncontrolled long-term asthma can lead to increased airway inflammation and a deterioration in lung function.
Asthma can be a complex and challenging condition to live with. But with proper management and support, people can still lead the life they choose. Maintaining a healthy lifestyle, and awareness of medication treatments is essential for people with asthma wherever they live. Education and encouragement of self-management can lead to healthier outcomes.
There are proactive measures which can make living with the condition easier and help you to achieve better outcomes:
- Keep on top of your medical regimen
- Use your inhaler correctly and check your technique, use preventer inhalers and prescribed medication
- Stop smoking (even social smoking)
- Exercise regularly – it will improve your lung function
Stopping smoking has a range of health benefits. There are many reasons for you to stop smoking, but if you smoke and you have a condition which affects your lungs, quitting is one of the best things you can do. Not only will you be able to manage your symptoms better, but you will be less out of breath and cough less. Exposure to tobacco smoke has decreased in Finland, and the country’s Tobacco Act aims to end the use of tobacco products by the year 20308.
Asthma does not have to stop you getting on with your daily activities. By putting in place small, manageable goals, you will manage your condition more easily. Creating the right plan with your doctor, sticking to that plan and keeping up with your medication, will all help in having a good day every day.
- Asthma international | Key facts revised May 2022. Asthma (who.int) (Accessed March 2023)
- Asthma Data Visualisations | Asthma UK | What we stand for. https://www.asthmaandlung.org.uk/about-us/what-we-stand-for (Accessed March 2023)
- Haahtela, T et al. The Finnish Allergy Programme 2008–2018 works. Eur Respir J 2017;49(6):1700470. https://erj.ersjournals.com/content/49/6/1700470
- Haahtela, T et al. A ten-year asthma programme in Finland: major change for the better. Thorax 2006;61(8):663–70. https://pubmed.ncbi.nlm.nih.gov/16877690/
- Hisinger-Mölkänen H et al. The increase of asthma prevalence has levelled off and symptoms decreased in adults during 20 years from 1996 to 2016 in Helsinki, Finland. Respir Med 2019;155;121–6. https://doi.org/10.1016/j.rmed.2019.07.014
- The Global Asthma Report (2018). http://globalasthmareport.org/2018/index.html(Accessed March 2023)
- Boulet LP. Asthma education: an essential component in asthma management.
Eur Respir J. 2015;46(5):1262-4. https://pubmed.ncbi.nlm.nih.gov/26521279/
- Tobacco-free Finland 2030. https://savutonsuomi.fi/en/ (Accessed March 2023)
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May 2023 / EASYH-3068
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