Tapas Mukherjee[/caption]Tapas Mukherjee, a respiratory registrar at Glenfield Hospital created the video using help from NHS colleagues in his spare time, after winning an award to develop his idea, from The NHS England Regional Innovation Fund in 2014. The video, which highlights hard hitting facts from the National Review of Asthma Deaths Report, aims to reduce the number of patients who are reliant on their emergency blue inhaler, encouraging them to see a doctor or nurse, and switch over to a regular inhaler instead.
Studies have shown that 80% of patients don’t know how to use an inhaler correctly and that using a blue inhaler more than twice a week is associated with increased chances of death.
Tapas explains further: “It’s amazing how many people, both patients and professionals, don’t know how to use inhalers properly. We hope to change that with this video, and if enough people see the message, we expect it will save someone’s life too.”
Mike Morgan, Consultant Physician in Respiratory Medicine at Leicester’s Hospitals and National Clinical Director for Respiratory Medicine for the UK added: “Good inhaler technique is fundamental to the effective treatment of asthma. Many asthma related deaths are related to poor understanding of inhaler therapy. Getting this message across to young people in particular is particularly challenging and I welcome this excellent innovative video.”
According to Asthma UK, someone in the UK suffers from a life threatening attack every ten seconds.
More than 90% of allergy and asthma sufferers in the UK don’t actually know what triggers their night time allergy and asthma symptoms, a problem which affects almost a third of the population.
The survey revealed 30% of sufferers experience interrupted sleep as a result of their symptoms.
When asked what they think the main triggers are, only 7% answered with dust mite faeces, even though up to a third of the weight of a two year old pillow can be made up of them, and 10 million of the creatures live inside the average bed.
What’s more, a third surveyed by Slumberdown admitted they didn’t even know what a dust mite is with a further 46% confessing to not actually knowing what a dust mite looks like.
In 2012 Allergy UK found that house dust mites were a trigger of an allergic reaction for around 58% of allergy sufferers.
Almost half (42%) thought hay fever was the main trigger, with 26% blaming dust closely followed by moisture in the air (23%).
Many people don’t realise the effects dust mites have on allergies and the fact it’s actually not the mite itself but the droppings which cause symptoms, with each mite producing about 20 of these droppings every day. A significant amount of exposure to house dust mite allergens happens in bed, and they also thrive in humid conditions so taking precautions such as using special bedding, can help prevent any wheezing or poor breathing.
Despite taking practical steps to eliminate dust mites such as vacuuming (49%), taking medication (46%), and opening the windows (41%). The UK could be doing more to help their symptoms, such as using bedding that protects against dust mites.
We interviewed Amena Warner of Allergy UK to mind out more.
PatientTalk.Org – Amena, can I ask, what is an Allergy?
Amena Warner– Well it’s a malfunction if you like of the immune system to something that would be quite natural within the environment or the food we eat. SO the immune system overreacts in an abnormal way to that thing that it’s been sensitives to.
PatientTalk.Org – What is the difference between night time and daytime allergies?
Amena Warner – Well often daytime allergies could be a food, it could be something in the environment, if it’s an outdoor allergen such as pollen causing hay fever symptoms but a night time allergy specifically can often be something within the home and often it’s within that bedroom environment. We’re talking about things like pets or mould but specifically about house dust mite because majority of people who have a night time allergy it’s often the house dust mite that may be contributing to that.
PatientTalk.Org – And why don’t people know about these night time allergies?
Amena Warner – Well if it’s the house dust mite, they might not even think about the house dust mite because they may not know about the house dust mite. Their microscopic little creatures that are a quarter of a millimetre long, so you wouldn’t actually see them with the human eye. So unless anyone told you about house dust mites, you wouldn’t know about them.
PatientTalk.Org – How can people go about avoiding night time and daytime allergies?
Amena Warner – Well first of all, it’s the symptoms you look out for. SO the symptoms; if there’s runny nose, itchy nose, itchy eyes, nasal blockage congestion, tightness of chest, coughing, wheezing, shortness of breath. That would alarm me to think something in the environment at night is causing the allergic problem. Asthma, tightness of chest, cough etc., if that’s left uncontrolled that can be very very dangerous. So they really need to go to the GP and get advice and medication on that. But if they do wake up in the night or early morning with symptoms it might be house dust mite allergies. So there is lifestyle things they can first try and avoid, things like encasing pillows and mattresses in anti-allergy bedding, taking them off very regularly at 60 degrees will kill the house dust mite.
Ventilation, opening windows don’t have the central heating on too high. So cooler, drier conditions are much better as house dust mites like warm humid conditions – they thrive in those conditions. So there the little lifestyle things that people can do to reduce the amount of house dust mite. It won’t eradicate them, because you can’t eradicate house dust mite, they’re in everybody’s household. What we try to do is reduce how many we have if you like. You won’t be able to see them, so you won’t know that they’re there. We have a whole big fact sheet and lots of information on our website.
PatientTalk.Org – Lastly, what is allergy UK and how does it help?
Amena Warner – Allergy UK is patient organisation and were an information charity for people with allergic disease or people may have symptoms that they think may be an allergy so they can find out more information. We do provide a helpline as well so people can phone up and if they want to know where their nearest allergy service is. So we are patient information charity to support people.
PatientTalk.Org – Where can people go for more information?
This morning I got a call from a PR agency asking me if I would like to contact and interview with a lady called Amena Warner from a charity called Allergy UK. It is looking at what causes night time triggers of night time asthma. I’ll be publishing the interview next week so do check back!
Anyhow as some background I thought I would share this rather useful infographic on asthma triggers.
If you have asthma (or any other allergies for that matter) can you share your triggers in the comments section below.
Western medical acupuncture is the use of acupuncture after a proper medical diagnosis. It is based on scientific evidence that shows the treatment can stimulate nerves under the skin and in muscle tissue.
This results in the body producing pain-relieving substances, such as endorphins. It is likely these substances are responsible for any beneficial effects seen with this form of acupuncture.
Traditional acupuncture is based on the belief that an energy, or “life force”, flows through the body in channels called meridians. This life force is known as Qi (pronounced “chee”).
Practitioners who adhere to traditional beliefs about acupuncture believe that when Qi does not flow freely through the body, this can cause illness. They also believe acupuncture can restore the flow of Qi, and so restore health.
Currently, the National Institute for Health and Care Excellence (NICE) only recommends considering acupuncture as a treatment option for chronic lower back pain, chronic tension-type headaches and migraines. NICE makes these recommendations on the basis of scientific evidence.
There is also some evidence that acupuncture works for a small number of other problems, including neck pain and post-chemotherapy nausea and vomiting.
Acupuncture is sometimes used for a variety of other conditions as well, but the evidence is not conclusive for many of these uses.
There is some scientific evidence acupuncture has a beneficial effect for a number of health conditions.
However, there is less clear scientific evidence about the benefits of acupuncture in the majority of conditions it is often used for.
The National Institute for Health and Care Excellence (NICE) only recommends considering acupuncture as a treatment option for chronic lower back pain, chronic tension-type headaches and migraine.
Assessing the evidence
One of the best ways researchers can assess the evidence behind a particular treatment is by carrying out a systematic review. This is a “study of studies” that combines findings from separate but similar studies to come up with an overall conclusion.
Systematic reviews are an important part of health research because they can identify findings that might otherwise be missed in individual studies. They can also help distinguish the effects of treatment from the effects of chance.
It is important to remember that when we use a treatment and feel better, this can be because of a phenomenon called the placebo effect and not because of the treatment itself. Systematic reviews can help reduce the potential influence of the placebo effect.
While systematic reviews cannot always determine conclusively whether a treatment does or does not work, they can be useful in assessing how a particular treatment (such as acupuncture) compares to another (such as “sham” acupuncture or medication).
However, even this can be challenging – both acupuncture and placebo treatments can stimulate the release of natural painkilling substances called endorphins, which can make it difficult to distinguish between them.
What evidence is there for acupuncture?
One of the largest and most respected organisations that carries out and publishes systematic reviews into the effectiveness of medical treatments is The Cochrane Collaboration.
A number of systematic reviews into the effectiveness of acupuncture have been published by The Cochrane Collaboration, and the basic results are summarised below.
Some positive evidence
Systematic reviews carried out by The Cochrane Collaboration have found there is some evidence acupuncture may have a beneficial effect on the following conditions:
However, because of disagreements over the way acupuncture trials should be carried out and over what their results mean, the existence of some positive evidence does not mean acupuncture definitely works for these conditions.
In many cases, the evidence appears contradictory. For example, some high-quality studies may suggest acupuncture is no better than “sham” acupuncture, whereas some lower-quality studies may suggest acupuncture is better than an established medical treatment.
The issue is sometimes also further complicated by the fact some “sham interventions” include active needling and are therefore not true placebos.
In addition, it can be difficult to make sure the patients involved in acupuncture studies are unaware of the specific treatment they are receiving (known as “blinding”).
This is because it is obvious whether you are receiving a conventional medical treatment such as medication or if you are receiving acupuncture, for example. This is a problem as it means the preconceptions of the person being treated may influence the result.
Some systematic reviews, however, have demonstrated the effects of acupuncture over sham treatment in studies where patients are unaware whether they are having real acupuncture or sham treatment.
For example, one large meta-analysis (a type of systematic review) not carried out by The Cochrane Collaboration included data from more than 17,000 patients. It compared acupuncture to sham acupuncture or no acupuncture without patients being aware of whether they had received real or sham treatment.
This review found acupuncture to be superior to both sham and no treatment for headaches, osteoarthritis, back pain and neck pain.
Little or no evidence
In many conditions where acupuncture is used, there is not enough good quality evidence to draw any clear conclusions over its relative effectiveness compared with other treatments.