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Asthma

Remembering to take medication for asthma

People who are taking a range of different medication may need to develop strategies to help them remember to take their medication regularly. A general rule is that regular inhaled steroids should be used by people who have day time symptoms twice a week or more, night time symptoms once a week, or who have had a flare up in the last 2 years.

Dee described herself as ‘an organised asthmatic’ and explained that her motivation to take the medication properly and every day was strong because she had experienced a very bad asthma attack some years ago and wanted to ensure that it didn’t happen again. She had developed a number of strategies to control her asthma including keeping inhalers in handy places and having a list of her medication by the phone in case of an emergency.

Several people said that they made sure to always have a reliever inhaler close to hand so that there wouldn’t be a panic if they started to feel their asthma was kicking in. Sometimes people asked their GP to prescribe several inhalers at a time so they could keep them in different places such as the car, the desk at work, their coat pocket or handbag.
 

The best piece of advice Dee was given when she was first diagnosed was to ‘be an organised asthmatic’ She has worked out ways to make sure she is able to manage her asthma that help her to feel she is in control. [AUDIO ONLY]

The best piece of advice Dee was given when she was first diagnosed was to ‘be an organised asthmatic’ She has worked out ways to make sure she is able to manage her asthma that help her to feel she is in control. [AUDIO ONLY]

Age at interview: 52
Sex: Female
Age at diagnosis: 23
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And I do remember being told quite early on, when I moved house and came to live in another area, I was given a very good piece of advice, which was that the best way to be asthmatic was to be an organised asthmatic. And that means keeping a note of your medication near your telephone or in your mobile phone or in the glove compartment of your car, or in your purse or something, so that if you’re ever, I don’t know, on holiday or away or you forget and you need to get to a pharmacy or whatever, you’re not guessing about it. Because even though you’re taking it regularly you can forget what the dose is and what the names of the drugs are. And the other thing was to take seriously the use of the preventative medicine and the third thing was, and I used to keep a diary in the early days. I kept a daily diary and then I got bored with that and kind of got to be able to live without it. The other thing was to keep a peak flow meter about your person. So I have one in my office and I have one at home and I have one in the car and I have one in the holiday home, which probably sounds a bit excessive, but if you wake in the night and you’re having difficulty breathing, yeah.

The next time I was hospitalised, I’ve only had that experience twice, I was hospitalised and nebulised and treated with prednisolone for another attack and that was because I misjudged how far down into breathing difficulties I was because I didn’t have a peak flow meter. And my reading had fallen below two hundred and I thought I’d feel great in the morning because this was the middle of the night and I didn’t. I just kept on feeling worse and at that point, there’s no point in using the reliever medication any longer because you’re well past that stage. So that taught me that, you know, your peak flow meter is an important piece of kit and they’re bulky, awkward things. It’s not the kind of thing you can keep in your handbag. Maybe one day somebody will invent a little neat, tidy handbag size one. But so then that’s what I do. I can go for years without needing medication or needing to think about it and if people ask me, you know if you’re filling in forms and they ask you about your health or whatever, I do have a tendency to forget that I’m asthmatic.
People mentioned other strategies that they said helped them to feel in control of their asthma, rather than letting it control them. Several people said they planned ahead, so that if they were going somewhere unfamiliar they would have a plan of what to do and where to get help if they felt unwell – what one person called ‘exit strategies’.
 

Jan has learned to be practical and plan ahead. ‘The lessons I’ve learned are never to take it for granted’.

Jan has learned to be practical and plan ahead. ‘The lessons I’ve learned are never to take it for granted’.

Age at interview: 46
Sex: Female
Age at diagnosis: 4
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I think I understand my asthma now, and it’s like when I was ill on Saturday I knew, you know, how much I could take of that environment before I’d got to remove myself from it. So I think it’s, I think the lessons I’ve learned are never to take it for granted. I mean I’m going to a friend’s house for overnight next weekend and there’s several friends going, and they were talking about sort of who’s going to sleep where, and I knew they’d got cats, so I just said, you know, “I don’t care what I sleep on, but I prefer to sleep in an environment where the cats so don’t spend a lot of time.” So it’s actually just planning. It’s being practical and common sense about what you do and where you go.

I think more people can get it under control. I mean, unfortunately not everyone can keep it under control, but and we all, I don’t worry that there won’t be a situation that I can’t manage, as long as I always have the inhaler, and can always get to a hospital. I mean I know when I need to get to a nebuliser or to, you know, to A & E for help.

And, as long as, and that’s why I left this party early on Saturday because I thought you know, it’s a boring leaving a party early but it would be even more boring if I ended up having to be called an ambulance and everyone’s night gets ruined. So it’s learning to look after yourself really.
At the same time people also worried that placing too much faith in their inhaler could cause problems. As Chris explained, "I did go through a stage where I was kind of addicted to it…I had to kind of educate myself as an adult out of this over-reliance on it, because I felt that if I was away from home and I didn’t have the inhaler I would have an attack. And it was a kind of self-fulfilling prophecy, because if I didn’t know I’d forgotten it I’d be fine."

It was sometimes hard to remember to take the preventer medication when people were feeling well, and some admitted that they had been through periods when they stopped using their inhaler because they weren’t experiencing symptoms and rather hoped they didn’t need it any more. On reflection, it was probably better to make this decision with a GP or asthma nurse. People also sometimes worry about long term effects of medication and understandably want to take as little as possible, but as Jan said, "the thing is with asthma, I think when you’re well you forget it, and that’s where the danger is…… but even when I’m at my most healthy I would always take the preventer."

Some people had worked out that they can take their preventative medication when they know they are at risk. Alastair, for example, said he only gets it in summer "I’m probably supposed to use it on an annual, you know, all the time, but kind of when it goes away you think you don’t need it. So… I stop using it when my asthma stops and then I start using the brown one when it kicks in again the next." (See ‘Managing asthma- reviews and action plans’).

Several people recommended making a routine around medicine taking as a way of reminding oneself, whether or not symptoms were present. Margaret gave this advice:
 

For Margaret the most important thing is to ensure that you are taking the medication correctly and regularly. ‘It’s just part of the morning and night routine, before you clean your teeth, you take your inhaler’.

For Margaret the most important thing is to ensure that you are taking the medication correctly and regularly. ‘It’s just part of the morning and night routine, before you clean your teeth, you take your inhaler’.

Age at interview: 62
Sex: Female
Age at diagnosis: 47
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It’s a routine I follow. I don’t risk my treatment, you know, I don’t miss taking my inhaler morning and night. That’s just so important, it’s just part of the morning and night routine, before you clean your teeth, you take your inhaler, breathe in, wait for ten seconds breathe out, if you need another dose you take it. And that’s been, you know, sort of, and I know it’s worked for me. So I just hope that anybody who is watching this and is worried, it’s worth just beating it. It’s a long term, at the moment a long term and what they call a chronic condition which I hate, I hate the terminology, but it doesn’t mean to say that it must rule your life.
Last reviewed August 2017.
 
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