On June 16, 2018, a press conference was held in Moscow with the participation of leading pulmonologists in Moscow and the Moscow Region, devoted to the problem of asthma.
The event was organized by the Russian Respiratory Society with the support of AstraZeneca and Philips within the framework of the Federal Social Program “Healthy Lungs”.
According to data provided by experts invited to participate in the press conference, the incidence of bronchial asthma grows 2 times every 15 years. Annually, 300 million people worldwide receive this diagnosis. Mortality is 250 thousand people per year – mostly, they are residents of poorly developed countries.
In Russia, according to the data of 2014, 5.6-12.1% of children and 5.6-7.3% of adults suffer from bronchial asthma. In total, the number of Russians with BA is estimated at 1.4 million. However, these are official statistics, that is, people who have gone to the doctor and received a diagnosis of bronchial asthma. In reality, the incidence is 5-6 times higher.
Chief Therapist of the Moscow Region and State Duma Deputy, MD, Professor N.P. Sanina told journalists about how the rights of patients with bronchial asthma (BA) are regulated at the legislative level today. In particular, N.P. Sanina referred to the Clinical Recommendations for Bronchial Asthma, which are now updated every 3 years, and spoke about the draft law “On Amendments to the Federal Law“ On the Basics of Citizen Health Protection in the Russian Federation ”developed by the State Duma deputies”. The document has already passed the first reading and is now at the stage of adaptation to the three-tier system of medical care in Russia. The deputy stressed that among the main problems in the field of legislative regulation of diagnosis, treatment and prevention of bronchial asthma the following points should be highlighted:
- Lack of connection between clinical recommendations, standards and clinical and statistical groups on the disease.
- The impossibility of assessing the size of the necessary financial and resource support for the country as a whole.
- Uncertainty of responsibility of the doctor.
- The absence of a specific list of medical services that should be provided to a patient with bronchial asthma.
The largest professional association that develops documents on bronchial asthma and works closely with government agencies is the Russian Respiratory Society (PPO). Today, it consists of 14 branches, uniting more than 2 thousand members. At the press conference, the RSO was represented by its president, the chief freelance pulmonologist of Moscow, MD, professor A.S. Belevsky .
According to him, thanks to the active work of RRO experts, over the past 20 years, it has been possible to reduce the mortality rate from bronchial asthma in Russia by more than an order of magnitude. As an indicator, such a severe complication, such as asthmatic status, with which every doctor was well acquainted 20-25 years ago, has practically disappeared. Clinical recommendations on BA, which are used today by domestic doctors, were also developed by specialists of the RRO with the support of foreign colleagues. Today, in close cooperation with the Ministry of Health, the professional standard of the pulmonologist is being developed.
The professor of the department of pulmonology at the Russian National Research Medical University named after Sh. N.I. Pirogov Z.R. Aysanov .
According to the speaker, today for asthma is characterized by a very low indicator of public concern of the society despite the fact that asthma is one of the most common diseases.
Over the past 40 years, both the attitude of doctors to asthma and the patient’s face have changed. The emergence of inhaled steroids nullified previously prevalent hormonal disorders that develop in patients with asthma, problems with injections, etc. Revolutionary changes in the fight against asthma brought its diagnosis, treatment and prevention to a fundamentally new level.
Z.R. Aysanov emphasized the problem of low detection of BA. According to experts, the real data on the incidence of an order of magnitude lower than official statistics. According to a study conducted under the guidance of Academician A.G. Chuchalina in 12 regions of the Russian Federation, the prevalence of asthma symptoms is 27%. In particular, this is due to the fact that patients are too late to go to the doctors. Most people with mild persistent asthma do not consider themselves ill and do not receive systemic basic therapy. The disease is progressing, and 60% of these patients go to primary care physicians when asthma reaches a new, more severe level.
The problem of early diagnosis also lies in the fact that between attacks of breathlessness during the examination a normal lung function is recorded in the patient. To identify the disease, it is necessary to use provocative methods. Science also does not stand still. The search for new biomarkers of bronchial asthma continues , fundamentally new diagnostic technologies are being developed – “electronic nose”, etc.
At the end of the press conference, the speakers clarified that bronchial asthma is an incurable disease. However, modern technologies and achievements of medicine already allow the disease to be brought into deep remission, so that the disease does not in any way affect a person’s life.Today, many famous athletes have a diagnosis of bronchial asthma, but this does not prevent them from winning even at world-class competitions.
Success in combating bronchial asthma can be achieved through a combination of three main components: early diagnosis of the disease, correct therapy and effective monitoring by patients.