World COPD Day: The Misuse Of Rescue Inhalers; How Self-Medication Worsens COPD

World COPD Day is celebrated annually on the third Wednesday of November. This day aims to raise awareness about chronic obstructive pulmonary disease (COPD) and encourages better prevention and management of the condition. This year, on November 19, World COPD Day focuses on the theme "Short of Breath, Think COPD." This year's theme highlights that although COPD is the third leading cause of death worldwide, it is often not diagnosed correctly.

For the unversed, Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung condition that causes breathing difficulties by blocking airflow. It is an umbrella term for a group of lung diseases, primarily emphysema and chronic bronchitis. Key symptoms of COPD include chronic cough, sputum production, wheezing, and shortness of breath, especially during physical activities. The primary causes of COPD are long-term exposure to irritants that damage the lungs, most notably tobacco smoke, air pollution, and occupational dust and chemicals.

Management of COPD

"In COPD management, we primarily use two different inhalers. The first is the rescue inhaler for a patient who develops sudden breathlessness or an acute symptom. The second is a preventive (controller) inhaler prescribed regularly to limit COPD deterioration and help control symptoms," explains Dr Ashish Jain, Director and Head Respiratory Medicine, Pulmonology at Max Smart Super Speciality Hospital, Saket.

Many individuals with COPD use rescue inhalers, which are fast-acting bronchodilators designed to provide quick relief from acute symptoms. While they are essential for managing sudden breathing difficulties, there is a growing concern about the misuse of these inhalers. Some patients may rely too heavily on them, treating symptoms without addressing the underlying disease progression.

"When patients start overusing their rescue inhaler, two possibilities usually exist. First, the dose or type of preventive inhaler they are on may not be adequate for the severity of their disease. Second, they may be ignoring their doctor's advice or prescription and relying only on the quick relief given by the rescue inhaler."

"Many patients feel that the rescue inhaler 'works better' than the preventive inhaler. This is a misconception. Rescue inhalers provide fast relief, but the effects are only temporary, so you feel better right away. Preventer inhalers work on a longer-term basis to reduce inflammation, prevent flare-ups and slow disease progression," says Dr. Jain.

Self-medication with rescue inhalers can mask the worsening of COPD. When individuals experience increased symptoms and repeatedly use their inhalers without seeking medical advice, they may overlook the signs of disease exacerbation or progression. This behaviour not only provides temporary relief but can lead to delayed treatment interventions that might be needed to better manage their condition.

Furthermore, frequent reliance on rescue inhalers can result in diminished effectiveness over time, leading some patients to increase their dosage without consulting healthcare professionals. This can expose them to higher risks of side effects and complications.

The expert further urges that it is very important to follow the prescribed treatment plan and not treat the rescue inhaler as a replacement for regular preventive therapy.

Additionally, pulmonary rehabilitation, lifestyle changes, and regular monitoring of the condition can help manage symptoms and improve quality of life.

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