According to recent statistics 6% children and 12% of adults in India have asthma. It is estimated 1 out of every 10 patients of asthma in the world is from India.While these figures may be alarming, what really is dreadful is that INDIA contributes to 42 percent of global asthma deaths, according to a report published online in Lung India journal related to respiratory medicine.
Inhaled corticosteroids like Budesonide or Fluticasone alone or with combination with drugs like formeterol are the mainstay treatment for Asthma .However, the patients are not getting the right medicine, according to recent statistics . This has been seen by high use of reliever medication like salbutamol(Asthalin). For the 34.3 million asthmatics in India, the total sales of inhaled corticosteroids should be 384 million units, but the actual sales in 2020-21 were only 26.4 million units. This means that more than 90% of asthmatics in India do not receive the right asthma medication.
Inhaled Corticosteroids (ICS) reduce the underlying inflammation in the airways, which is the characteristic feature of asthma, and reduce the airway swelling, spasm and mucus hypersecretion. ICS use has been shown to reduce asthma deaths and suffering in the western world. The number of asthma deaths in the world are actually declining, but in India asthma deaths have increased significantly over the past three decades, most likely due to underuse of ICS, and overuse of the inhaled bronchodilator drugsIt is inhaled bronchodilators which give immediate relief that are the most widely used inhaled medications for asthma. However, they do not reduce the underlying inflammation and therefore make the disease more chronic and are associated with more hospitalisation and deaths
We need to practice a healthy and guideline based approach while treating asthma, which clearly states combination of ICS with formeterol as both maintenance and reliever therapy.All asthmatics must receive inhaled corticosteroids as a standard treatment. This not only reduces the risk of dying, but also improves quality of life and reduces suffering .We also need to address the proper technique, dose and frequency of inhalers as the most important cause of worsening of asthma condition is improper technique .