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For decades, treatment of Asthma has involved two different types of inhalers, explains Johannesburg-based GP Doctor Marlin McKay, who practices at the Goldman Medical Centre.

“Many asthmatic patients use a maintenance inhaler which contains an anti-inflammatory medicine; they also use a symptom reliever inhaler which is blue in colour and contains an item which opens up the airways, also known as short-acting beta-2-agonists (SABA). ^1,2 Asthma patients frequently underuse anti-inflammatory maintenance therapy, and instead over-rely on SABA reliever therapy which provides rapid and temporary relief. The problem with this approach is that it can mask the worsening of symptoms and actually increases the risk of Asthma attacks.” ^3-6 In fact, just three or more puffs of the blue inhaler per week increases a patient’s risk of Asthma attacks.^1-3,7,8

The link between SABA blue reliever inhalers over-reliance and an increased risk of Asthma attacks has led to updated recommendations from GINA. These recommendations are provided for people using these specific inhalers and advises them to avoid establishing a pattern of reliance on SABA early in the disease. ¹

GINA no longer recommends SABA blue reliever inhalers alone as the preferred reliever therapy, and instead recommends the use of a low dose inhaled corticosteroid (ICS)-formoterol therapy as needed as the preferred reliever therapy across all Asthma severities. ¹ This combination inhaler contains an anti-inflammatory agent which reduces inflammation in the airways that is associated with Asthma.

Dr McKay affirms that “many patients feel dependant on their SABA blue inhaler, mistakenly believing this to be the best way to control their symptoms. Having said that, it’s important to understand firstly what over-reliance looks like, and this is where the “Reliever Over-Reliance Test” comes in.

“I strongly urge that everyone living with Asthma should take the test – it’s easy to navigate and will help them understand whether they are relying too heavily on their SABA. If the results indicate over-reliance, then that information can facilitate conversations with their healthcare professional around their Asthma management.”

“Recognising that the use of SABA blue inhalers to control Asthma symptoms actually increases the risk of Asthma attacks, ^1,10,11 action to correct asthmatic compliance has never been more important. When you consider that South

Africa’s prevalence of Asthma is among the highest in the world and we are ranked fifth for Asthma mortality ¹², the case for better control is clear.”