Asthma: a chronic disease still poorly managed in France

A chronic disease... still too often trivialized

Asthma affects between 6% and 8% of the French population and is responsible for 60,000 hospitalizations every year. This pathology manifests itself as inflammation of the bronchial tubes, leading to episodes of respiratory discomfort, wheezing and coughing, varying in intensity from patient to patient. Contrary to popular belief, this is not a one-off illness. It is a chronic inflammatory disease that evolves throughout life, with phases of lull that can give the illusion of a cure, without it being real. In reality, this chronic dimension is still poorly integrated. Asthma is too often considered as a simple antecedent, and not as a pathology requiring regular, structured follow-up; a trivialization contributing to insufficient and sometimes inappropriate management.

Practices still far from recommendations

International recommendations, notably those of the Global Initiative for Asthma (GINA), have profoundly changed the way the disease is managed. They emphasize a major change: treatments based solely on short-acting bronchodilators are no longer suitable. Now, the use of inhaled corticosteroids is recommended, including in patients with infrequent symptoms. But these recommendations are still unevenly applied, particularly in primary care medicine, due to a lack of time, training or knowledge of the various suitable treatments.

900 deaths per year: a figure that is still unacceptable. A key issue: better information and coordination

In France, asthma is responsible for around 900 deaths every year, a significant proportion of which occur among children and adolescents.This figure is all the more worrying given that, in many cases, these deaths could be avoided through early diagnosis, improved compliance with treatment and appropriate management of exacerbations. Emergency room visits for severe exacerbations are still all too frequent, and testify to the current limits of management. In this respect, post-exacerbation follow-up is crucial.

Faced with these findings, one of the major challenges is to train the various healthcare professionals involved and harmonize messages.

Prevent rather than cure

Experts from the F-CRIN-labeled "CRISALIS" national network remind us that asthma management must be part of a whole patient approach, integrating environmental and behavioral dimensions. Exposure to allergens and pollution, as well as lifestyle habits such as smoking, vaping and diet, play a decisive role. Physical activity is also encouraged, provided it is adapted and experienced in a positive way, as an element of quality of life and not as a constraint.

Digital tools and monitoring applications can help improve compliance, provided they are adapted to patients' uses and expectations. In this context, certain artificial intelligence solutions capable of facilitating access to scientific recommendations for healthcare professionals could also play an increasing role in the years to come.

Beyond treatments, research is increasingly focusing on prevention. In particular, current work is exploring the impact of the environment from the earliest stages of life, including during pregnancy. The aim is to better understand the interactions between genetic and environmental factors in order to limit the onset and worsening of the disease.

Major appointments

To find out more about all the latest news on asthma, an appointment for healthcare professionals with the world's leading experts, accessible online will take place on the occasion of World Day on May 5: an ERS / Respiratory channel Round Table from 5pm to 6pm. Registration: ICI (fee for non-ERS members).

Initiatives to raise awareness of respiratory health issues, aimed at the general public and supported by the Fondation du Souffle, are also deployed throughout the year, with a highlight on May 5 and throughout the month in numerous healthcare establishments.