Kilkenny has the fourth highest rate of reliever inhaler overuse in the country

The Asthma Society of Ireland is today releasing research conducted by hmR Ireland which looks at the over-reliance on reliever inhaler medication by people with asthma in each county in Ireland. Reliever inhalers, which most people will recognise as the blue inhalers, if over-used, are strongly linked with severe asthma exacerbations and asthma related deaths.

Using three or more reliever inhalers a year indicates a person is at risk of a severe asthma exacerbation while the use of twelve or more a year is an indication someone is at risk of an asthma-related death.

Kilkenny

In the year of diagnosis, Kilkenny had the fourth highest rate of reliever inhaler overuse in the country at 20%. In the year after diagnosis, that number nearly doubled to 37% of people who overused their reliever inhaler. By year five, 44% of people with asthma in Kilkenny were overusing their reliever inhaler.

The results also found:

Three in ten use more than 12 reliever inhalers a year, putting them at risk of an asthma-related death
Seven in ten are using more than three reliever inhalers a year, putting them at risk of an asthma attack (or some form of asthma exacerbation)
In the year after diagnosis, 30% children aged 0-17 are overusing their reliever inhaler
In the year after diagnosis, 60% people aged 50 or over are overusing their reliever inhaler
Sarah O’Connor, CEO of the Asthma Society of Ireland, said: “Today’s hmR research revealed that a huge proportion of people in all age groups are overusing their reliever inhalers in every county throughout Ireland, putting them at risk of an asthma severe exacerbation or asthma related death.

If you are using your reliever inhaler several times each week, you are over-reliant on it and your asthma is not controlled. The exception to this is people with asthma who participate in sport/exercise, where it is still recommended you use your reliever inhaler prior to warming up before exercising.”

The Asthma Society is calling on all people who are over-reliant on their reliever inhaler to act now to get their asthma in control. People with asthma should take the following actions:

Download an Asthma Action Plan from asthma.ie
Complete your Asthma Action Plan with your healthcare professional and speak specifically about your usage of your asthma medications
Call the Asthma Society’s free Asthma and COPD Adviceline on 1800 44 54 64 to help you understand asthma, its triggers and how to manage it, and to better understand your asthma control
This Asthma SafetyCare campaign and the hmR research is supported by AstraZeneca.

The HMR Research also revealed a trend where reliever over-use scales up drastically after the first year and is very high by five years after initial diagnosis:

In the initial year of diagnosis, one in five people overuse their reliever inhaler.
In the year after diagnosis, there is: a 6% increase in the number of people using 12 or more reliever inhaler a year (2% to 8%) and a 17% increase in the number of people using three or more reliever inhalers per year (16% to 33%). There is a corresponding drop of 23% of people using two or less (considered the appropriate amount) reliever inhalers per year (82% to 59%).
In the year after diagnosis the following numbers of people over-use their reliever inhaler: three out of 10 children aged 0-7, three out of ten children aged 7-17, two out of five people aged 18-32, half the people aged 31-50, and three out of five people aged over 50.
To reduce asthma-related deaths and exacerbations, the Asthma Society of Ireland today launches its over-arching Asthma SafetyCare campaign, an initiative aiming to end asthma deaths in Ireland by making patients and public aware of asthma management issues. The Asthma Society hopes the Asthma SafetyCare campaign will make a tangible difference to asthma deaths by combatting problematic aspects of asthma management, with this first project looking at SABA over-reliance.

For anyone with asthma, or for anyone who cares for someone with asthma who would like to speak to someone about their inhaler usage, the Asthma Society of Ireland runs a free Asthma and COPD Adviceline. Users of the service can speak to a respiratory specialist nurse who will work with them to assess if they are overusing their reliever medication and review their asthma control.  The free Asthma and COPD Adviceline is available on 1800 44 54 64.

The Medical Director of the Asthma Society of Ireland, Marcus Butler, said: “A reliever inhaler works within minutes to relieve asthma symptoms when they happen - it gives a short-lived improvement in symptoms, effectively just buying time, but can eventually fail to keep a patient safe from asthma if more appropriate and effective controller inhalers are not used on a daily basis. A controller inhaler works over a much longer duration than reliever inhalers to eventually ease the underlying airway inflammation which ultimately causes asthma symptoms. It prevents symptoms from arising several weeks and months down the road, as long as it is habitually taken.

The UK’s National Review of Asthma Deaths report (2014) showed that there was evidence of excessive prescribing of reliever medication: 39% of those who died had been prescribed more than 12 short-acting reliever inhalers in the year before they died, and 4% had been prescribed more than 50 reliever inhalers. Those prescribed more than 12 reliever inhalers were likely to have had poorly controlled asthma.”