Asthma is a treatable disease, and most people who have asthma should be able to achieve lasting asthma control. The two main strategies are trigger avoidance and medication. In this post, I'll cover some of the main reasons why people don't always take their asthma medication as planned. I'll also talk about some solutions to breaking through those barriers to achieve better asthma control.
What Types of Medication Treat Asthma?
There are 2 main approaches to treating asthma with medication:
- Controller/preventer medication, such as an inhaled steroid that is taken daily to prevent symptoms
- Rescue medication, such as a broncodilator that can be used as needed when symptoms flare up
The most common method of delivery is an inhaler, a small handheld device that sprays an aerosolized version of the medicine directly into your airways. I covered all the different types of inhalers on our COPD site (most of these medicines are also used for asthma).
What Is Medication Compliance?
Compliance simply means that you take your asthma medication according to the way it is prescribed. This includes:
- Taking it at the right time
- Taking it in the right amount
- Taking it at the right frequency
- Using proper technique with the inhaler
Sounds easy, right? Unfortunately, many people don't have great asthma control and one of the main reasons is due to poor medication compliance. Let's take a look at some of the reasons why this might happen.
#1: "I feel great and I'm not having symptoms, so I must not need my medication right now."
Let's face it -- most of us don't like having to take medication every day. It might be the inconvenience and time it takes to use the inhaler. It might be that you don't like putting chemicals into your body or being dependent on medication to stay healthy.
SOLUTION: Learn all you can about your prescribed medications. Asthma medicines don't keep working if you stop taking them. The reason you feel great is because you have been taking the medication. But if you're thinking you might not need the medicine any longer, talk with your doctor as an equal partner in planning your asthma care. Maybe there ARE changes that can be made.
#2: "I'm afraid of the side effects."
There is a lot of misinformation available these days about health topics. So-called experts expound at length on blogs and social media about the "dangers" of western medicine. But not everything you read on the Internet is true.
SOLUTION: Side effects with most asthma medicines are relatively few, mild and usually subside over time. But if you're concerned, learn everything you can about the medicine from a reliable source. Also, talk with your pharmacist, doctor or other healthcare professional about your concerns.
#3: "I can't afford my asthma medications."
This is a tough one. I've lived through it myself, in the 12 years I went with no health or pharmacy insurance. Asthma inhalers are pricey... often more than $100 for a one-month supply.
SOLUTION: There are a number of creative ways to lessen the financial burden of asthma medication, including health insurance. One of the other health pros here, Dr. Thompson, wrote a great post with tips for How to Save Money on Your Asthma Medications.
#4: "I forget to take my daily inhaler until I start to notice asthma symptoms." OR "I ran out of my medication."
Most of us lead busy lives. It's easy to forget to take medication or to get a prescription refilled when you're hurrying to get out the door to work or school, or if your daily to-do list is a mile long. But it's important to take your asthma inhaler or other medicine at roughly the same time each day every day, if you want to get the optimum benefit.
SOLUTION: Include taking your medication on your daily calendar or planner. Leave the medication out in your bathroom or kitchen where it is highly visible. There are also smartphone apps that you can set up to give you audible and visible reminders to take your medicine and to get your monthly refills. Keep a log of when you use your inhaler, so you know when it's about to run out.
#5: "It's easier just to use my rescue inhaler whenever I start to have symptoms."
Most people who have moderate to severe asthma, or even mild persistent asthma, do need to take a daily preventer or controller medicine. The rescue inhaler is only to be used when symptoms still crop up. Needing to use a rescue inhaler more than twice a week is a sign that your asthma is not well-controlled. That matters because when asthma is poorly controlled over a long period of time, serious, even life-threatening complications can develop.
SOLUTION: Take your daily controller medicine! If you start to have symptoms, keep a log of how often, when and where they occur. Don't hesitate to talk with your doctor about whether your medication plan can be pared down or minimized to some extent. It might be possible.
#6: "I'm not sure I'm using my inhalers properly, because I don't feel any medicine coming out."
If you've had asthma long enough to remember the old CFC-type inhalers, then you remember how you could feel the coolness and force of the medicine being sprayed into your airways as you depressed the canister. That type of inhaler was phased out a few years ago due to environmental concerns. The newer HFA-type of inhaler just doesn't have the same feel. It's really hard to tell if the medicine is going into your airways or not.
SOLUTION: Ask your doctor's support staff or your pharmacist to go over proper inhaler technique with you. If you're using the right technique, then you should be getting the proper amount of medicine.