Managing medications

For people with severe asthma, medication forms an important part of their asthma management. People we interviewed talked about the types of medications they were prescribed including inhaled medications, oral steroids, biologicals and other medications. See Overview of Medical Care. Often they had other illnesses as well as asthma, which meant other medications to take in addition to their asthma medications.

Clive is on a new biological medication for severe asthma.

Rachel has arthritis and a history of stroke as well as the asthma.

From a medical perspective, effective asthma self-management in adults involves managing medications through keeping to the agreed treatment program, monitoring asthma control, and using of inhaler devices for asthma medicines correctly. [Australian Asthma Handbook]. Reliever inhalers (‘puffers’) are used when people have asthma symptoms, and also prior to exercise in some cases. Preventers are taken regularly, every day, to prevent asthma symptoms and flare-ups, and help soothe the irritation or inflammation inside the lungs. [National Asthma Council]

Michael spoke of the two sides to medication taking­ ‑ preventative and “as it happens”.

Ed checks his lung capacity using a peak flow meter.

Over the course of their severe asthma journey, people we interviewed had been prescribed lots of different medications, and often it was a case of trial and error. Although certain medications seemed good on paper, in practise they might not work as well as expected.

Clive ticked all the boxes for some medications but didn’t get any benefit.

Leanne was eventually prescribed an older medication.

Establishing and maintaining a routine for asthma medications was seen as important by people we talked to. They found that remembering to take medications was easier in the mornings, and more than one person admitted to sometimes forgetting night-time doses of medication. Although it is vital to keep on top of the asthma, organising and taking medications does take quite a bit of time out of the day. Strategies used by people in the study to correctly take their medications included keeping them all in one place as well as lining them up and counting them.

Marion has several medications to take before she goes to work.

Justin is on automatic pilot.

Effective self-management of asthma in adults also includes having an up-to-date written asthma action plan. People we interviewed talked about the importance of having an action plan to follow if their asthma worsens.

Margie ups the dose if her normal dose is not effective.

People with severe asthma talked about needing to be organised with medication supply such as having access to relievers wherever they were for the peace of mind.

Regarding travel, there was a range of experiences. Some people we interviewed were practical and explained that they stocked up if travelling to regional areas of Australia where supply might be tricky. Others said they couldn’t travel as they have to have weekly injections.

Allen keeps a stash of Ventolin but also has a back-up plan in case of emergency.

Whilst people we talked to understood the importance of regular use of their asthma medications, side effects were an important consideration affecting self-management. People with severe asthma accepted that steroids were essential for getting the disease under control at times, however they ascribed many different side effects to steroids including weight gain, reflux, moon face, cataracts, diabetes, hair loss, mood changes (both elevated and depressed), bruising, osteoporosis and broken bones. They expressed that the cure was sometimes worse than the disease itself but had to be endured as severe asthma is life threatening. Often there would need to be a medication added to the list to treat the side effects of another medication.

Ed finds steroids affect sleep.

Karen has found steroids interfere with everything.

Wayne describes how using one medicine results in another.

Medication side effects were not just a problem with steroids. Puffers caused many people with severe asthma to have a very dry throat. Leanne has to take antihistamines regularly because of the biological injections.

Jemma finds the reliever puffers make her shake.

Severe asthma has been quite costly for people we talked to, including the need to have operations due to the side effects of steroids. Medication costs played into decision making for some participants as money spent on medications means it can’t be used for other things.

For Tony, side effects from steroids have led to a lot of operations and expense.

Justin is on a pension but it’s still difficult.