Hika Alert! Over-Reliance on Quick Relief Asthma Inhalers Tied to 69% of Asthma Hospitalizations, Warn Experts

Medical experts from various specializations are urgently calling for improved asthma care in the Philippines, where an estimated 98% lack access to adequate outpatient asthma care.

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During the media roundtable on August 15, 2024, at Romula Cafe in Makati, theAsianparent had the opportunity to join leading medical experts as they highlighted the urgent need for better asthma care in the Philippines.

The event, attended by key figures in the healthcare industry, including Dr. Maria Janeth Samson, president of the Philippine College of Chest Physicians; Dr. Guia Limpoco, trustee of the Philippine Academy of Family Physicians; Dr. Anna Marie Putulin, president of the Philippine Academy of Pediatric Pulmonologists; and Dr. Cyril Tolosa, medical affairs director of AstraZeneca Philippines, underscored the critical importance of proper asthma management to prevent avoidable attacks and hospitalizations.

In photo (L-R): Dr. Anna Marie Putulin, President of Philippine Academy of Pediatric Pulmonologists; Dr. Maria Janeth Samson, President of Philippine College of Chest Physicians; Dr. Guia Limpoco, Trustee of Philippine Academy of Family Physicians; and Dr. Cyril Tolosa, Medical Affairs Director, AstraZeneca Philippines

The medical experts from various specializations are urgently calling for improved asthma care. Studies indicate that inadequate treatment of this chronic lung disease, which affects people of all ages, is creating significant challenges for Filipino families and the broader health sector.

According to the World Health Organization (WHO), asthma is often underdiagnosed and undertreated in low- and middle-income countries like the Philippines.¹ A study from The Lancet further revealed that an estimated 98% of Filipinos lack access to adequate outpatient asthma care.² The same research highlighted that nearly half of Filipinos with asthma have inadequately controlled conditions, making them susceptible to attacks or hospitalizations.

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Given this disparity, it is crucial that Filipinos receive the correct treatment whenever possible. Dr. Samson of the Philippine College of Chest Physicians emphasized that the high reliance on short-acting beta 2 agonists (SABA) or asthma inhalers like salbutamol is a sign of poor asthma control.

A study published in the Acta Medica Philippina journal³ revealed that an estimated 69% of hospital admissions due to asthma are from uncontrolled or partly-controlled cases. Dr. Samson also referenced the Canadian SABA In Asthma (SABINA) longitudinal study, which concluded that overuse of SABAs is linked to an increased risk of severe attacks.

“The quick relief provided by SABAs often leads patients to over-rely on this medication,” Dr. Samson explained.

The solution, doctors suggest, involves a more balanced approach centered around the use of inhaled corticosteroids (ICS). The Global Initiative for Asthma (GINA) recommends a combination ICS-formoterol inhaler, which not only relieves symptoms but also reduces the risk of asthma attacks.⁴ As both a reliever and controller of asthma, ICS-formoterol is preferred by GINA over SABA, which only provides symptom relief.

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Dr. Limpoco of the Philippine Academy of Family Physicians and Dr. Putulin of the Philippine Academy of Pediatric Pulmonologists echoed Dr. Samson’s call. These practices are aligned with the ultimate goal of long-term asthma management,4 which includes preventing severe attacks and maintaining lung function.

“Asthma treatment is a family affair,” said Dr. Limpoco, a primary care physician, stressing the importance of a support system in managing asthma. “We have to ensure proper techniques are used, as incorrect methods can prevent symptom control.”

Dr. Putulin, a pediatric pulmonologist, expressed optimism, emphasizing that the science behind asthma management is well-established. “We aim to train children early and address issues from a young age,” she said, encouraging an active lifestyle among children. “We want them to live normally, including participating in sports.”

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Dr. Tolosa of AstraZeneca Philippines reaffirmed the company’s commitment to advancing asthma care equity, driven by its goal to eliminate asthma attacks and achieve clinical remission for all patients.

“It will take the entire health ecosystem—including the government, private sector, patient groups, and healthcare experts—to transform asthma care in the country,” Dr. Tolosa stated.

AstraZeneca is championing respiratory health through initiatives like Breathe Better, a campaign raising awareness about the risks and complications of asthma and chronic obstructive pulmonary disease. The campaign’s official page has over 38,000 Facebook followers, underscoring the urgency of empowering more Filipinos.

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In partnership with the PAFP, AstraZeneca advocates for the Asthma Action Plan, a simple tool recommended by GINA to help patients manage their asthma. In 2023, AstraZeneca also collaborated with PAFP, PCCP, and Mercury Drug to launch Asthma Care Hub, the first in-store end-to-end healthcare solution for asthma patients. Currently, there are 14 hubs in Mega Manila.

Agham Kapihan is a series of media roundtable discussions that aim to shed light on important health and science issues while advocating for innovations that benefit Filipinos. Supported by AstraZeneca, these forums are part of the company’s commitment to improving the lives of millions of patients in collaboration with partners across the healthcare ecosystem.

References:
1. World Health Organization. (2024, May 6). Asthma. [WHO Fact Sheet](www.who.int/news-room/fact-sheets/detail/asthma)
2. Noorduyn SG, Qian C, Johnston KM, et al. SABA use as an indicator for asthma exacerbation risk: an observational cohort study (SABINA Canada). ERJ Open Res 2022;8:00140-2022. [DOI:10.1183/23120541.00140-2022](doi.org/10.1183/23120541.00140-2022)
3. Fernandez, L., & Zamora, M. (2021). An Assessment of Epidemiologic Burden of Hospitalization for Bronchial Asthma in Acute Exacerbation among Adult Patients Admitted in a Tertiary Hospital in the Philippines: A Pilot Study. *ACTA Medica Philippina*, 55(1).
4. Global Initiative for Asthma. (2024, May). Global Strategy for Asthma Management and Prevention (2024 Update). [GINA Report](ginasthma.org/wp-content/uploads/2024/05/GINA-2024-Strategy-Report-24_05_22_WMS.pdf)

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