Asthma stigma is deterring patients from using inhalers

Stigma about asthma is discouraging people with the condition from using their inhalers in public and from taking sick leave from the workplace to seek medical care, according to new findings from an Asthma Australia survey.

The findings released as part of Asthma Week (1-7 September) show that almost 50% of people who have asthma or care for someone with asthma said they would feel uncomfortable to use an asthma puffer in public.

A similar proportion of people – one in two of those with asthma – said they felt their workplace does not view asthma as a valid reason to take sick leave.

The online survey of 1030 adults was commissioned by Asthma Australia and conducted by YouGov between 4 – 8 August 2022.

Commenting on the findings, respiratory physician Dr John Blakey of the Sir Charles Gairdner Hospital, Perth, said the negative impacts of stigmas on people with asthma could results in underuse of medication and worsening asthma control.

“Being stigmatised for having asthma means people are less likely to take their treatment. This leads to them being more overtly symptomatic, and therefore more obviously have asthma. This vicious circle leads to avoidable harm,” he said.

“Taking inhalers is an obvious point of difference that can lead to stigma and bullying, although there are some notable exceptions – like Olympic swimmer Ian Thorpe or soccer star David Beckham. We need more successful people to be open about this aspect of this life.”

Dr Blakey said asthma stigma in the workplace could results in stress, shame and reluctance to seek medical help.

“Hiding the condition might be literally not telling an employer they have it, but it can also manifest as coming to work when unwell – being present but less productive for fear of being labelled in your absence,” he said.

Asthma Australia CEO Michele Goldman as a first step, workplaces need to be more transparent about asthma in their sick leave policies, to better support employees which will reduce stigma.

“Asthma is a diagnosed health condition for 2.7 million people, and takes the life of a person each day, it’s a workplace responsibility. Adults spend a vast majority of time at work, and this is where a lot of stigma and health issues can take place,” she said.

The survey findings also suggested that the COVID-19 pandemic has intensified stigma around the asthma cough, with results showing 43% of people admitting if they saw someone coughing, they would assume they are contagious. This was reflected in an Asthma Australia COVID-19 survey which found most people with asthma reported feeling stigmatised by their asthma symptoms appearing like COVID-19.

Asthma Australia said it also wants health professionals to be aware of the way their interactions can contribute to experiences of stigma and the impact this has on patient health care access.

“The first step to  reversing the experiences of stigma related to health care is to consider a person-centred approach. Person-centredness in asthma appreciates the whole person and their context and the relationship between and influence of these factors on asthma health. Combining person-centredness with supported self-management in asthma; a model that builds self-efficacy through education, encouragement, reinforcement, reassurance, and feedback, has great capacity to reduce stigma,” it said.

“If you don’t have time for this in a consult or you don’t have access to an asthma educator in your practice or hospital, you can refer your asthma patients to Asthma Australia’s Asthma Educator Service for free.”

“Referring patients to get extra help will show them you do care about them living confidently with asthma, and it could be an important gesture that may help your patient overcome their perceived stigma.”

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