Asthma education in India, a call for action

We are no strangers to witnessing the detrimental impact of irritants present in the air on humans. The presence of these irritants often leads to wheezing, coughing, and shortness of breath, which significantly affects the quality of life. This chronic condition affects millions globally, but it is particularly prevalent and severe in India, with an estimated 37.9 million Indians who have asthma (1). The high numbers account for 28 per cent of the global disease burden (2). Apart from the high number of sufferers, asthma also contributes to a significant number of deaths and disability-adjusted life years, making it a major public health concern that requires lifelong management and treatment (3). Unfortunately, many people with asthma do not have access to adequate diagnosis, medication, or education, resulting in inadequate management and an increased risk of complications and even death.

The Air Quality Life Index reported a significant decline of over 67 per cent in the last ten years, leading Indians susceptible to respiratory diseases, including asthma. The deterioration of air quality is estimated to reduce life expectancy by 5.3 to 11.9 years (4). This surpasses the impact of more serious health issues like cardiovascular disease (4.5 years) or malnutrition (1.8 years). Thus, it becomes crucial to empower patients, caregivers, and healthcare professionals with knowledge and resources to better understand and take appropriate actions to prevent and treat the negative impact on public health. 

Prioritising Awareness and Detection 

Early detection and intervention are crucial in healthcare and holds true for all medical conditions. Educational campaigns that raise awareness about the risks, causes, symptoms, and triggers of asthma pave the path for early detection. A robust healthcare infrastructure that dispels myths and stigma associated with asthma is also essential. Access to detection programs, including screening tests, peak flow, and spirometry, can play a pivotal role in early diagnosis, identifying people who have undiagnosed asthma or even those at risk of developing it (5). By prioritising awareness and detection, people can be empowered to seek timely medical attention and effectively manage their condition, while healthcare professionals can provide the necessary support, guidance, and treatment. 

Enabling Treatment and Adherence 

Access to effective and affordable treatment options is crucial for asthmatic patients. Asthma treatment revolves around fast-acting rescue medicines, nebulizers, and inhalers, depending upon the severity of the condition (6). While medicines help ease asthma symptoms and reduce sensitivity to asthma triggers, inhalers are the most effective way to deliver asthma medicine to the lungs (7). While the Government of India, through the National Programme for Disease Prevention, covers asthma as a non-communicable disease and provides free treatments, the biggest challenge patients face is the proper use of inhalers to achieve optimum results. To address this issue, JAI, India’s first digital asthma educator platform, has educated over ten thousand patients on the correct technique of using different types of inhalers on their journey towards improving lung health.

Promoting Autonomy and Empowerment

As asthma impacts the day-to-day lives of individuals, limiting their ability to work, travel, and effectively care for their loved ones, empowering them holds the key to improved quality of life. By providing disease knowledge, support groups, self-management programs, and digital tools, patients can effectively manage their conditions, thereby increasing adherence to treatment plans and preventive measures (8). With positive improvements on a day-to-day basis, patients’ experience reduces healthcare costs and decreases episodes of emergency doctor visits and hospitalisations. The Government of India empowers patients through the Pradhan Mantri Bharatiya Janaushadhi Pariyojana and the Jan Aushadhi Scheme by providing free medicines, including inhalers, nebulizers, and oral drugs, to asthma patients at affordable prices (9). The government has also collaborated with international partners to promote the fight against chronic respiratory diseases and advocates for improved asthma programs nationally.

Asthma education plays a vital role in empowering patients to make informed decisions and lead healthier lives. It is equally essential to address and to dispel deep-rooted myths and misconceptions surrounding the disease. Asthma, often undervalued as a non-serious condition, can, in fact, be life-threatening if untreated. The National Clean Air Programme, an initiative of the Government of India is a commendable effort towards controlling and reducing particulate pollution levels in India (10). However, to truly make a difference in burden of asthma, it becomes crucial to proactively protect individual lives and ensuring public-private collaboration in raising awareness about asthma and its education. 

References:

1. World Allergy Organ J. 
2. ERJ Open Res.
3. Int J Environ Res Public Health. 
4. https://aqli.epic.uchicago.edu/country-spotlight/india/ 
5. Cureus. 
6. https://aafa.org/asthma/asthma-treatment/ 
7. https://www.webmd.com/asthma/asthma-treatments 
8. PLoS One. 
9. https://janaushadhi.gov.in/pmjy.aspx 
10. https://pib.gov.in/PressReleaseIframePage.aspx?PRID=1909910#:~:text=82%20cities%20under%20NCAP%20have,annual%20average%20Particulate%20Matter10%20(PM10)