Mumbai: Dr Vikas Gupta, India Business Rx Head, Cipla spoke to Prabhat Prakash of ETHealthworld on the impact of asthma on the life of children and how collaboration among stakeholders is key in the healthcare system in driving patient-centric initiatives, utilising various channels and championing mass awareness and patient support efforts. Edited Excerpts.
What is the current landscape of paediatric asthma in India?
Asthma is one of the most common chronic conditions among children, affecting nearly 7.9 per cent of Indian children. The presence of allergic rhinitis, genetic predispositions ie, if there’s a family history of asthma, exposure to environmental factors like tobacco smoke, usage of smoke-producing fuel (firewood/cow dung/kerosene) at home, traffic-related air pollution, all have a role in developing asthma.
Children are particularly vulnerable to asthma as their immune systems are still developing. Nearly 80 per cent of asthmatics experience symptoms during the first six years of their life. Unfortunately, if asthma is overlooked and inadequately treated, it can significantly impact a child’s quality of life. The disease can greatly restrict the ability to participate in regular daily activities, such as sports and outdoor pursuits. It can lead to difficulty in sleeping, fatigue, and even long-term decline in lung function. Globally, each year, asthma results in over 10 million missed school days and ranks as the third leading cause of hospitalisations in children. A study conducted in India showed that among children aged six to seven years, approximately 66 per cent experienced absences from school or other activities because of wheezing, while 44 per cent had been hospitalised at least once in the past year due to breathing difficulties.What are the most common symptoms of paediatric asthma?
The most common symptoms of asthma include coughing, wheezing (a whistling sound when breathing), a feeling of tightness in the chest, and difficulty breathing. These symptoms can occur from time to time and can be triggered by various factors like colds, exercise, allergies, and exposure to smoke, they often worsen at night affecting a child’s ability to sleep.
What is the prevalence of paediatric asthma in the economically backward strata of society? How can the accessibility and affordability gap be bridged?
The prevalence of asthma in India is estimated to be around 7.9 per cent in urban areas and 6.8 per cent in non-urban areas. One possible explanation for the higher prevalence of asthma among wealthier populations in India is their improved access to healthcare. The better healthcare systems available to those with higher economic status enable the diagnosis and identification of asthma cases. On the other hand, lower socio-economic groups in India may face underdiagnosis and under-reporting of asthma due to limited access to healthcare resources. This means that the actual prevalence of asthma among these groups could be higher than reported.
Essentially, awareness efforts need to be adequately met by an ecosystem that enables better access to screening avenues, treatment channels as well as assistance throughout the patient journey through education – to make a meaningful impact.
Our approach addresses barriers and social stigmas surrounding asthma and its cornerstone treatment ie, inhalation therapy. It also emphasises the significance of early diagnosis and treatment of asthma. Collaboration among stakeholders in the healthcare system is crucial to driving these patient-centric initiatives, utilising various channels and championing mass awareness and patient support efforts.
What are the key challenges in diagnosing and treating asthma, and how can pharmaceutical companies contribute to overcoming those challenges?
Early detection, diagnosis and treatment are pivotal to the effective long-term management of asthma in children. However, asthma in children can be difficult to diagnose. This is because symptoms like chronic cough, wheezing and/or shortness of breath in children are associated with several other childhood conditions as well. While lung function tests like peak expiratory flow (PEF) and spirometry can be used to aid the diagnosis of asthma in children over the age of five years, for younger children diagnosis is largely based on the presenting symptoms of the patient and a detailed history taking on the part of the clinician.
The treatment goals in children and adolescents are to reduce day-to-day symptoms, improve sleep quality, enhance physical activities, and minimise the risks of asthma attacks. To achieve this, it is crucial to evaluate significant risk factors, follow the prescribed medications - regular use of maintenance treatments, as prescribed and provide consistent and high-quality parental education.
As the primary influence in a child’s life, especially for medical decisions and forming future perceptions about important aspects of their self-care – parents, guardians as well as caregivers need to be empowered and equipped with the right information to make informed decisions.
However, lack of awareness and understanding about the disease as well as its treatment often leads to parents hiding the condition due to societal concerns or delaying treatment until symptoms worsen due to myths associated with inhalation therapy. This ultimately leads to the improper treatment and management of the disease. Therefore, engaging children between the ages of five and 10 years as well as their parents through campaigns which focus on respiratory care, plays a vital role in combating stigma and creating a nurturing environment for children with respiratory conditions including asthma to thrive.
What was the business perspective behind foraying into the paediatric asthma market? What is your vision for the future of paediatric asthma management, and how can pharmaceutical companies drive that vision forward?
Right from promoting awareness, diagnosis, and medication to advanced treatments and devices, our commitment to respiratory care extends across the spectrum of services, with the singular aim of helping patients breathe better. We believe that an attitudinal and behavioural shift towards a disease can be driven through adequate empowerment and consistent support given to both patients as well as the healthcare network. We’ve been driving this ambition through a multidimensional approach.