A recent study by the Asthma & Allergy Association (AAA) Singapore, the leading patient-centred organisation for people with asthma and allergies in the country, has revealed that poor asthma control has a significant impact on mental health and wellbeing among adult patients. The study found that nearly 70% (67%) of adult respondents reported that they often or always feel down because of their asthma and more than half (56%) said that they feel embarrassed to admit that they have asthma.

In addition, 80% of adults surveyed experienced physical activity limitations in the last four weeks due to asthma. Asthma is a chronic inflammatory airway disease that affects approximately 5% and 20% of adults and children in Singapore respectively¹. It can cause serious symptoms which can affect daily lives and make people feel down.

The study of 400 asthma patients in Singapore, including 250 adults between the ages of 18 to 65, with asthma and 150 parents of children below 18 with asthma was conducted in August this year. It examined how those with asthma perceive their conditions, how it impacts their lives and the steps they are taking to improve how they manage asthma.

Asthma impacting daily life

The survey found that 88% of adults surveyed woke up at least once at night in the last month due to asthma symptoms. Both adults and children also experienced wheezing, coughing and shortness of breath commonly during the day. 80% of adults experienced activity limitation at least once in the last month because of their asthma condition, while a lesser proportion of children (46%) or their parents reported activity limitations.

More worryingly, almost 80% of adult respondents went to the hospital at least once in the last year because of severe asthma symptoms. In fact, in Singapore, asthma-related emergency department visits and hospitalisations are 2 to 3 times higher than other developed countries².

Poorly managed asthma has a significant impact on patients’ physical and mental wellbeing, their loved ones and society as a whole. As measures from the COVID-19 pandemic eased, there has been an increased number of patients seeking treatment for acute upper respiratory infections – which affects patients with asthma more significantly.”

– Dr Adrian Chan, Respiratory Specialist and President of the Asthma & Allergy Association (AAA)

Blue inhaler use

Singapore’s national guidelines for asthma management recommend that all people with asthma aged 6 years or over should not solely use a blue inhaler³. Using the blue inhaler three or more times a week is a sign that asthma isn’t as well-controlled as it should be, and can put patients at risk of an asthma attack, while masking the worsening symptoms⁴. Instead, most people with asthma should use a preventer inhaler as the main way to control asthma.

“It is crucial for patients to work closely with their doctors, understand the risks of over-reliance on the blue inhaler and adhere to their preventive medication on a consistent basis. This will help to address the root cause of asthma – inflammation in the lungs. Although there is no cure for asthma, patients can manage the condition well and greatly improve their quality of life, ” added Dr Chan.

Encouragingly, a small proportion of respondents – less than 9% of adults (8.7%) and 5% of children used the blue inhaler more than three times in a typical week, an improvement from patients’ use of the blue inhaler, when surveyed in 2020. 5 However, 60% of adult respondents think that the blue inhaler is the best way to keep on top of symptoms, with almost half (48%) of them believing that the blue inhaler is the only treatment they can rely on.

Treatment and support from healthcare professionals

When it came to the first point of contact to finding out more about asthma, people tend to rely on healthcare professionals in Singapore. Close to half of adults (48%) and more than half of children (61%) and their parents first sought advice from a general practitioner, while 29% of adults and 20% of children went to a respiratory specialist.

People also sought treatment from their healthcare professional within a short time frame after experiencing asthma symptoms – more than 1 in 2 adults (59%) and almost half of children (44%) sought treatment within a month of experiencing their first symptoms. Majority of all respondents also felt that they received enough information and support from their doctors , although many wished to understand more information about the different medications and their side effects.

Patients may also want to opt for oxygen concentrators at home to help alleviate symptoms while sleeping. Please visit http://www.aaa.org.sg/ for more information on how to manage your asthma more effectively.

To check if you are over-reliant on the blue inhaler, please visit rateyourreliance.sg.

References:
¹ Epidemiology & Disease Control Division MoH, Singapore. National Health Survey 2010.
² OECD Health Statistics 2015 http://dx.doi.org/10.1787/health-data-en, Accessed September 2022
³ Agency for Care Effectiveness. Asthma — optimising long-term management with inhaled corticosteroid https://www.ace-hta.gov.sg/healthcare-professionals/ace-clinical-guidances-(acgs)/details/asthma-optimising-long-term-management-with-inhaled-corticosteroid, Accessed September 2022
⁴ Global Initiative for Asthma (GINA) 2021. Global Strategy for Asthma Management and Prevention: https://ginasthma.org/wp-content/uploads/2021/05/GINA-Main-Report-2021-V2-WMS.pdf, Accessed September 2022
⁵ Asthma & Allergy Association Singapore. Beat the Asthma Blues Report:
http://www.aaa.org.sg/newsnevents/beat-the-asthma-blues-report-overcoming-asthma-to-live- a-fulfilling-life-in-singapore/, AccessedSeptember2022