Recent analysis from Asthma UK has revealed that as many as 26,000 people could be hospitalised with asthma this winter. Meanwhile the Office for National Statistics revealed that there were excess winter deaths last year – and a third of these were from respiratory conditions.
Winter can be particularly problematic for people with asthma. As we know, cold weather, colds, the flu and even dust mites from putting on the central heating can all trigger a life-threatening asthma attack.
So, how can you spread the word to your patients about how they can reduce the risk of being hospitalised this winter? Here are my top tips:
1. Explain how preventer inhalers work
As doctors we understand the importance of patients taking preventer medicines but sometimes getting this message to stick is a challenge, especially because it’s all too easy for routines to slip at Christmas. You can tackle this by explaining to patients the importance of taking their preventer inhaler as prescribed. It builds up protection in their airways over time, making them less sensitive to triggers if they do come into contact with them.
Once people form habits, it’s easier for them to keep to them. You could suggest they make taking their inhaler part of their daily routine – such as doing it just before brushing their teeth.
2. Reiterate the importance of always carrying a reliever inhaler
Asthma symptoms and asthma attacks can be unpredictable, so it’s worth reminding patients to take their reliever inhaler everywhere with them – especially if they are going away this winter.
It’s also important to highlight that what a reliever inhaler can’t do is deal with the underlying inflammation that’s causing the symptoms. Flag the warning signs to your patients so they know when to get urgent medical help. For example, if they need their blue reliever inhaler three or more times a week it means their asthma isn’t well managed and an asthma attack could be triggered.
You should also remind them to attend their yearly asthma review and use a written asthma action plan. Research shows that patients are four times less likely to need a hospital stay if they use one.
3. Warn patients about festive triggers
Your patients might be surprised to know that the Christmas season can also present a whole host of festive triggers. Christmas trees, scented candles, open fires, even the sulphites in wine and processed meat such as pigs in blankets can all set-off people’s asthma symptoms.
Avoiding these triggers can be difficult, especially when patients are visiting family or friends’ homes over Christmas. Reassure patients that following simple tips including taking their preventer inhaler every day and always having their reliever inhaler on them will help them to stay well so they can concentrate on enjoying themselves.
Also, if they know that something can trigger their asthma symptoms then they should try to avoid it. Encourage them to be proactive and not to put their health at risk.
4. Promote the flu jab
Colds and flu viruses - which are rife at this time of the year - are the number one trigger for asthma, affecting an estimated 4.4m people in the UK. There’s been a lot in the news recently about the flu jab not being effective last year, but it is still the best way for people with asthma to stay protected if it triggers their asthma.
It’s not too late for your patients to get the flu vaccine so do encourage them to have it – and explain how flu can exacerbate asthma. It’s worth explaining that the vaccine is reviewed every year following advice from the World Health Organisation so it will be completely different this year compared to previous years.
5. Prepare your patients for holiday season
So that patients can avoid the stress of running out of medicines over the Christmas break, it’s worth asking them whether they have the right supplies of medicine. Explain to them that this is one of the best things they can do to make sure they have a symptom-free Christmas. Stocking up on asthma medications before their GP surgery and local pharmacy shut for the festive season is a must.
Remind patients of surgery opening hours and what they should do if they have an asthma attack and where to get help if they need it.
Apart from Christmas week, your patients can get advice from asthma nurses through the Asthma UK helpline on 0300 222 5800 or via WhatsApp on 07378 606728.
6. Teach your patients the scarf hack
Cold air is a major trigger for asthma attacks with 4m people with asthma in the UK saying that breathing it in makes their asthma symptoms worse.
The humble scarf can be a good defence, so if cold air is a top trigger for your patients, you could suggest they wear a scarf over their nose and mouth can reduce the risk of them having an asthma attack, as it can warm up the air before they breathe it in. It’s also worth advising patients to try to breathe through their nose rather than the mouth, as the nose is designed to warm the air as you breathe it in.
- Dr Andy Whittamore is clinical lead at Asthma UK and a GP with a specialist interest in asthma. If your patients want to find out more about winter triggers and practical tips encourage them to visit: www.asthma.org.uk/wintertriggers