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PROBLEMS OF ASTHMA MANAGEMENT IN PAKISTAN
BURDEN OF ASTHMA <ul><li>ASTHMA IS ONE OF THE MOST COMMON CHRONIC DISEASE WORLDWIDE </li></ul><ul><li>PREVALENCE INCREASIN...
HOW COMMON IS ASTHMA IN PAKISTAN <ul><li>THE MAGNITUDE OF THE PROBLEM IS NOT CLEARLY KNOWN </li></ul><ul><li>APPROXIMATELY...
HOW GOOD ARE WE MANAGING ASTHMA <ul><li>POOR COMPLIANCE IS ONE OF THE MAJOR PROBLEMS IN MANAGEMENT OF ASTHMA AND LACK OF K...
SOCIAL STIGMA <ul><li>IT IS NOT A CONTAGIOUS DISORDER  </li></ul><ul><li>PATIENTS DO NOT ACCEPT DIAGNOSIS DUE TO DISCRIMIN...
DIAGNOSIS OF ASTHMA <ul><li>PATIENTS ARE OFTEN MISDIAGNOSED AS HAVING CHEST INFECTIONS OR BRONCHITIS </li></ul><ul><li>IGN...
FALSE HOPES AND DOCTORS SHUFFLING <ul><li>ASTHMA CAN NOT BE CURED BUT CAN BE VERY WELL CONTROLLED  </li></ul><ul><li>THERE...
MISUSE OF STEROIDS <ul><li>CORTICOSTEROIDS ARE THE MOST COMMON MEDICATIONS FOR ASTHMA MANAGEMENT WHICH IS BEING USED THROU...
MISCONCEPTIONS ABOUT INHALERS <ul><li>INHALER DEVICES ARE THE BEST METHOD OF DELIVERING ASTHMA MEDICATIONS </li></ul><ul><...
POOR TECHNIQUE OF INHALERS <ul><li>EIGHTY PERCENT(80%) OF ASTHMATICS IN PAKISTAN STILL USE SYSTEMIC THERAPY i.e. ORAL AND ...
EXCESSIVE USE OF NEBULIZERS <ul><li>PATIENTS MAY USE THEIR NEBULIZER REPEATEDLY AND DELAY SEEKING MEDICAL HELP IN SEVERE A...
DESENSITIZATION VACCINES AND ASTHMA   <ul><li>IMMUNOTHERAPY HAS PROVEN NOT TO BE OF MAJOR BENEFIT IN ASTHMA AND THERE IS A...
OVER USE OF AMINOPHYLLINE IN ACUTE ATTACKS <ul><li>AMINOPHYLLINE SHOULD NOT BE THE FIRST DRUG TO BE GIVEN IN ACUTE ATTACKS...
DIET AND ASTHMA <ul><li>ASTHMA CAN ALSO BE PROVOKED BY A WIDE RANGE OF FOODS , ADDITIVES AND PRESERVATIVES </li></ul><ul><...
DISSEMINATION OF GUIDELINES AND ADHERENCE TO GUIDELINES <ul><li>THE DEVELOPMENT OF GUIDELINES IS A LABOURIOUS PROCESS AND ...
COST OF TREATMENT   <ul><li>COST OF TREATMENT OF INHALED CORTICOSTEROIDS IS A BIG CHALLENGE AND NEED TO BE TACKELED  </li>...
WHAT CAN WE LEARN FROM RECENT RESEARCH ON ASTHMA? <ul><li>LONG ACTING BETA AGONISTS SHOULD NOT BE USED AS MONOTHERAPY IN A...
WHAT CAN WE LEARN FROM RECENT RESEARCH ON ASTHMA? (CONT’) <ul><li>LEUKOTRIENE MODIFIERS NOW HAVE A MORE PROMINENT ROLE AS ...
WHAT CAN WE LEARN FROM RECENT RESEARCH ON ASTHMA? (CONT’) <ul><li>MONOTHERAPY WITH CROMONES IS NO LONGER GIVEN AS AN ALTER...
KEY NOTE MESSAGE <ul><li>IN ORDER TO CONTROL ASTHMA PHYSICIAN MUST BE A GOOD LISTENER AND EDUCATOR </li></ul><ul><li>WITH ...
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Asthma management

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Transcript of "Asthma management"

  1. 1. PROBLEMS OF ASTHMA MANAGEMENT IN PAKISTAN
  2. 2. BURDEN OF ASTHMA <ul><li>ASTHMA IS ONE OF THE MOST COMMON CHRONIC DISEASE WORLDWIDE </li></ul><ul><li>PREVALENCE INCREASING IN MANY COUNTRIES ESPECIALLY IN CHILDREN </li></ul><ul><li>OVER 300 MILLION ASTHMATIC WORLDWIDE </li></ul><ul><li>GLOBAL ECONOMIC COST EXCEED THAT OF TB HIV COMBINED </li></ul>SOURCE :CHEST JULY 2006
  3. 3. HOW COMMON IS ASTHMA IN PAKISTAN <ul><li>THE MAGNITUDE OF THE PROBLEM IS NOT CLEARLY KNOWN </li></ul><ul><li>APPROXIMATELY 10% OF ADULTS AND 20% OF CHILDREN IN PAKISTAN ALONE ARE SUFFERING FROM THIS DISEASE </li></ul><ul><li>THIS DISEASE IN OUR COUNTRY IS STILL UNDER DIAGNOSED AND POORLY TREATED </li></ul>
  4. 4. HOW GOOD ARE WE MANAGING ASTHMA <ul><li>POOR COMPLIANCE IS ONE OF THE MAJOR PROBLEMS IN MANAGEMENT OF ASTHMA AND LACK OF KNOWLEDGE AND UNDERSTANDING ABOUT THE DISEASE IS THE REASON FOR POOR COMPLIANCE </li></ul>
  5. 5. SOCIAL STIGMA <ul><li>IT IS NOT A CONTAGIOUS DISORDER </li></ul><ul><li>PATIENTS DO NOT ACCEPT DIAGNOSIS DUE TO DISCRIMINATION IN SOCIETY </li></ul>
  6. 6. DIAGNOSIS OF ASTHMA <ul><li>PATIENTS ARE OFTEN MISDIAGNOSED AS HAVING CHEST INFECTIONS OR BRONCHITIS </li></ul><ul><li>IGNORANCE ABOUT THE DISEASE IS COMMON AMONGST ASTHMA PATIENTS AS WELL AS DOCTORS </li></ul>
  7. 7. FALSE HOPES AND DOCTORS SHUFFLING <ul><li>ASTHMA CAN NOT BE CURED BUT CAN BE VERY WELL CONTROLLED </li></ul><ul><li>THERE ARE FALSE CLAIMS MADE BY QUACKS AND UNPROFESSIONAL DOCTORS CLAIMING TO CURE ASTHMA </li></ul><ul><li>IT IS USUALLY A LONG TERM VARIABLE LIFETIME DISORDER PRESENT EVEN WHEN THERE ARE NO SYMPTOMS </li></ul>
  8. 8. MISUSE OF STEROIDS <ul><li>CORTICOSTEROIDS ARE THE MOST COMMON MEDICATIONS FOR ASTHMA MANAGEMENT WHICH IS BEING USED THROUGHOUT THE WORLD.IT SHOULD BE GIVEN IN INHALER FORM </li></ul><ul><li>EIGHTY SEVEN PERCENT (87%) ASTHMA PATIENTS HAVE NEVER TAKEN OR HEARD ABOUT INHALED CORTICOSTEROIDS </li></ul>
  9. 9. MISCONCEPTIONS ABOUT INHALERS <ul><li>INHALER DEVICES ARE THE BEST METHOD OF DELIVERING ASTHMA MEDICATIONS </li></ul><ul><li>THERE ARE MANY MISCONCEPTIONS ABOUT INHALERS AMONGST ASTHMA PATIENTS AND DOCTORS </li></ul>
  10. 10. POOR TECHNIQUE OF INHALERS <ul><li>EIGHTY PERCENT(80%) OF ASTHMATICS IN PAKISTAN STILL USE SYSTEMIC THERAPY i.e. ORAL AND PARENTAL </li></ul><ul><li>EVEN THOSE ON INHALED MEDICATIONS OVER 90% ARE ON INHALED BRONCHODILATORS AND ONLY 10% ARE ON INHALED CORTICOSTEROID THERAPY </li></ul>
  11. 11. EXCESSIVE USE OF NEBULIZERS <ul><li>PATIENTS MAY USE THEIR NEBULIZER REPEATEDLY AND DELAY SEEKING MEDICAL HELP IN SEVERE ASTHMA. IT IS SAID THAT </li></ul><ul><li>“IF YOU NEED A NEBULIZER , THEN YOU NEED TO SEE A DOCTOR” </li></ul>
  12. 12. DESENSITIZATION VACCINES AND ASTHMA <ul><li>IMMUNOTHERAPY HAS PROVEN NOT TO BE OF MAJOR BENEFIT IN ASTHMA AND THERE IS ALSO A RISK OF DEVELOPING SERIOUS ALLERGIC REACTIONS TO THE INJECTIONS </li></ul>
  13. 13. OVER USE OF AMINOPHYLLINE IN ACUTE ATTACKS <ul><li>AMINOPHYLLINE SHOULD NOT BE THE FIRST DRUG TO BE GIVEN IN ACUTE ATTACKS OF BRONCHIAL ASTHMA </li></ul><ul><li>SIDE EFFECTS ARE COMMON </li></ul>
  14. 14. DIET AND ASTHMA <ul><li>ASTHMA CAN ALSO BE PROVOKED BY A WIDE RANGE OF FOODS , ADDITIVES AND PRESERVATIVES </li></ul><ul><li>FOODS: EGGS , PEANUTS AND SHELFISH </li></ul><ul><li>PRESERVATIVES: TARTRAZINE (ORANGE COLOURING) AND SULPHITES (ALCOHOLIC DRINKS SUCH AS WINE) </li></ul>
  15. 15. DISSEMINATION OF GUIDELINES AND ADHERENCE TO GUIDELINES <ul><li>THE DEVELOPMENT OF GUIDELINES IS A LABOURIOUS PROCESS AND ITS DISSEMINATION AMONGST RESEARCHERS, DOCTORS AND PATIENTS IS A DIFFICULT TASK </li></ul>
  16. 16. COST OF TREATMENT <ul><li>COST OF TREATMENT OF INHALED CORTICOSTEROIDS IS A BIG CHALLENGE AND NEED TO BE TACKELED </li></ul><ul><li>DOCTORS HAVE A RESPONSIBILITY TO USE MEDICATIONS APPROPRIATELY BECAUSE OF THE HIGH COST INVOLVED </li></ul>
  17. 17. WHAT CAN WE LEARN FROM RECENT RESEARCH ON ASTHMA? <ul><li>LONG ACTING BETA AGONISTS SHOULD NOT BE USED AS MONOTHERAPY IN ASTHMA AND MUST ONLY BE USED IN COMBINATION WITH AN APPROPRIATE DOSE OF INHALED GLUCOCORTICOSTEROIDS </li></ul>
  18. 18. WHAT CAN WE LEARN FROM RECENT RESEARCH ON ASTHMA? (CONT’) <ul><li>LEUKOTRIENE MODIFIERS NOW HAVE A MORE PROMINENT ROLE AS CONTROLLER TREATMENT IN ASTHMA PARTICULARLY IN ADULTS </li></ul>
  19. 19. WHAT CAN WE LEARN FROM RECENT RESEARCH ON ASTHMA? (CONT’) <ul><li>MONOTHERAPY WITH CROMONES IS NO LONGER GIVEN AS AN ALTERNATIVE TO MONOTHERAPY WITH A LOW DOSE OF INHALED GLUCOCORTICOIDS IN ADULTS </li></ul>
  20. 20. KEY NOTE MESSAGE <ul><li>IN ORDER TO CONTROL ASTHMA PHYSICIAN MUST BE A GOOD LISTENER AND EDUCATOR </li></ul><ul><li>WITH PROPER MANAGEMENT ALMOST ALL PATIENTS WITH ASTHMA CAN LEAD A NORMAL LIFE </li></ul>
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