Inhalation Therapy: Helping Patients Manage COPD
By Dr. Sushmita Roy Chowdhary, In charge in Critical Care Medicine and Internal Medicine, Apollo Hospital.
Holding on to the wall and gasping for air, Sushil Jain reaches for the door of his apartment with a racing heart. As he catches his breath, he realizes how much his health had deteriorated since he was diagnosed with Chronic Obstructive Pulmonary Disorder (COPD).
COPD is a lung disease that damages the airways inside the lungs, causing chest tightness, shortness of breath and persistent cough.
“Every breath feels so labored and forceful that my eyes widen out. It takes its toll on your daily routine; even having a normal conversation looks so difficult because all you can think about is your next breath,” says Dr. Sushmita Roy Chowdhary, In charge in Critical Care Medicine And Internal Medicine, Apollo Hospital.
At first when Sushil’s symptoms appeared, he dismissed them as smoker’s cough or the result of “bad weather”. But gradually it grew more vicious. During bad spells, he had to take strong steroids. But instead of getting relief from the condition, the steroids caused various side-effects, including swollen face, bone weakness, and high blood pressure.
According to the World Health Organization (WHO), there are millions who share the fate of Sushil Jain and bear the brunt of this life-threatening disorder. Worse still, this medical condition continues to grow exponentially on account of lack of awareness, ignoring the early symptoms, delayed diagnosis, improper management and not adopting to effective medical aid.
“COPD is a substantially under diagnosed disorder that often goes unnoticed until the disease is advanced. Spirometry is one of the most common breathing test used to confirm the diagnosis of COPD. This is a painless test involving breathing into a mouthpiece and tubing connected to a small machine”, says Dr. Sushmita Roy Chowdhary, In charge in Critical Care Medicine And Internal Medicine, Apollo Hospital.
“Based on the condition, you may be advised to take additional lung function test such as a chest X-ray, or a test to measure the level of oxygen in your blood. Timely detection helps in making an objective measurement of airflow obstruction and assessing the degree to which it is reversible”, adds Dr. Sushmita Roy Chowdhary, In charge in Critical Care Medicine And Internal Medicine, Apollo Hospital.
WHO claims that COPD affects about 210 million people world-wide. In India, it is rising at alarming rate. As per WHO, in 2016 over 22 million people are suffering in India.
A decade ago, COPD was the fifth leading cause of death and is projected to become the fourth-largest cause of death worldwide by 2030.
Showing its grave concern over the lethality of the rampant increase in the number of cases of COPD, the WHO decided to observe World COPD Day on November 18 every year. The move is aimed at spreading awareness among the public as well as the medical professionals about the dreaded disease.
Realizing the urgent need to aware and educate people about effective medical aid for COPD,
Cipla had launched a mass media campaign #BerokZindagi to encourage and educate patients suffering from Obstructive Airway Disease (OAD). The campaign also focuses to break the misconception about the inhalers and to create an awareness on Inhalation Therapy as the smart choice to combat the illness.
On the poor adherence to treatment of COPD and disparities in the standards of care, Dr. Sushmita Roy Chowdhary, In charge in Critical Care Medicine And Internal Medicine, Apollo Hospital. says, “The clock is ticking when it comes to barring this disease from spreading at this high rate. It gets rather difficult to control the symptoms when timely medical interventions are not adopted. Also, to overcome the inequalities in healthcare, there is an urgent need to use clinically effective and safer treatment modalities, such as inhalation therapy, greater awareness and rehabilitation programs as well as use of patient-driven data to improve patient outcomes.”
Although, COPD is incurable, but by adopting healthy lifestyle (quitting smoking, undertaking regular activity), avoiding pollution and resorting to COPD treatments, such as inhaled corticosteroids, you can alleviate the symptoms and improve the quality of life.
Experts believe that inhalation therapy is safer and clinically more effective than oral medication in the long term.
“Inhaled corticosteroids directly reach the damaged airways. In this case, only miniscule quantity of the drug is sufficient to relieve the symptoms, limiting the risk of adverse systemic reactions,” adds Dr. Sushmita Roy Chowdhary, In charge in Critical Care Medicine And Internal Medicine, Apollo Hospital.
Compared to this, oral corticosteroids are given in very heavy doses (about 10,000 mg) as compared to inhaled corticosteroids (about 20-25 mg) due to different route of administration.
“In contrast to inhaled therapy, oral corticosteroids first dissolve in the bloodstream and through various organs it reaches the affected airways. In the process, the drug is inevitably absorbed by other parts of the body where it is not required, and which may cause systemic side-effects,” says Dr. Sushmita Roy Chowdhary, In charge in Critical Care Medicine And Internal Medicine, Apollo Hospital.
According to a study published in the Annals of Family Medicine, the risk-benefit ratio is far more in favour of inhaled corticosteroids (localized drug delivery) as compared to tablets and syrups (systemic drug delivery) in patients with moderate to severe COPD.
“Considering the clinical efficacy and safety, people suffering from COPD should be considered for inhalation therapy, depending on the requirement and severity of the disease,” says Dr. Sushmita Roy Chowdhary, In charge in Critical Care Medicine And Internal Medicine, Apollo Hospital.
People often dismiss the severity and fatality of COPD, either because they haven’t heard much about it or they think it is a non-serious condition, but nothing could be further from the truth.
In number terms, COPD is galloping ahead of well-known diseases like malaria and TB. And going ahead, this gap is expected to get wider, reveals another study published in the Journal of Thoracic Disease.
However, with education, awareness programs, prevention efforts and effective therapy, you can safeguard yourself from this life-threatening disease. Experts believe that as more people are educated about it, fewer will actually contract the disease.