Asthma deaths: an avoidable toll
Although health care in Spain could be considered among those in the highest standards of the world, and access to asthma medicines is virtually free, this condition still kills many more people that it should. According to Eurostat, asthma has been causing around one thousand deaths each year, from 2011 to 2019. This figure is higher than in France and much higher than in Italy (both countries with considerably more numerous populations). Most of those deaths could had probably been avoided. In fact, in the UK, an audit performed by the Royal College of Physicians and summarised in the National Review of Asthma Deaths (NRAD) in 2014, found that two-thirds of asthma deaths could have been prevented by better basic care (Chapter 4).
Apart from the general health care system, including family doctors and paediatricians in primary health care centres and specialists based in hospitals; scientific societies dealing with asthma, both in children and in adults, have been joined together for more than two decades, to provide the best possible and updated information on how to manage asthma. This effort is summarised in “Guía Española para el Manejo del Asma” (GEMA) (https://www.gemasma.com). Additionally, several isolated local initiatives to implement specific asthma plans have been launched in the past.
What might be the problem?
So, if all the necessary instruments are there, what might be the problem? Probably coordination and awareness of the importance of the disease are the main problems. Having 16 different regional authorities does not help the coordination. Awareness should be easy to achieve as, according to the last GAN survey, the prevalence of asthma-related symptoms in children 6-7 and 13-14 years of age and adults are, respectively, 10.4%, 15.3% and 13.7%. If more than 10% of the population (more than five million people in the country) has asthma, how can this be ignored by health authorities? Probably because the death rate among asthmatics is low: as low as the number of deaths from traffic accidents.
How this can be improved?
Improving awareness and information about asthma among health care professionals and patients to achieve better treatment adherence is crucial: a national asthma programme, like that of Finland, would be a great advance not only to decrease the death toll but also to reduce the cost of the disease.