Last June, I did a potentially dangerous thing: I stopped taking Advair, the asthma medication I'd been on for years. I hoped to find that I'd outgrown the need for a twice-daily inhaler. The only way to know for sure, I reasoned, was to try going without it. It's a mistake that many people make, it turns out—and for which they often pay in health problems later on.
Admittedly, quitting my medicine without talking to my doctor first wasn't a smart move. I did fine for a while. But by the fall, I'd developed a raging sinus infection that lasted for four months and chest pains and wheezing that the doctor blamed on my asthma. Back on Advair I went, after a scolding by my doctor not to stop again.
So it didn't surprise me to hear about the findings of a new observational study, presented at the American Academy of Allergy, Asthma & Immunology's annual meeting in March: that asthmatics who stop taking Advair during the summer months are more likely to end up in the hospital and emergency room than those who keep taking their medicine. The results held true regardless of age—people studied ranged from 4 to 55. The research was sponsored by Advair's maker, GlaxoSmithKline, and was based on a healthcare claims database of more than 45 participating health plans. About 4.8 percent of asthmatics ages 19 to 55 who skipped Advair during the summer required an emergency room visit in the fall, compared with about 2.9 percent of those who continued taking their medicine during the summer. A similar trend was observed among those ages 4 to 18.
The reasons patients stop taking their medicine vary, experts say. Some, like me, tire of the daily regimen. I'd been on a daily inhaler of some form or another since 1992, when I was first diagnosed with asthma at age 11. My situation is not unusual, says Todd Mahr, a pediatric allergist at Gundersen Lutheran Medical Center in LaCrosse, Wis. Mahr, who wasn't involved in the study but has received speaking fees from drug companies, says that those who've been taking daily asthma medications for years may wonder, "Have I outgrown this?"
Children may just fall out of their daily routine during the summer. "They're sleeping until noon," says lead study author Ketan Sheth, medical director of the Lafayette Allergy and Asthma Clinic in Lafayette, Ind.
The takeaway message is to think twice about a summer break, unless you get your doctor's or the pediatrician's OK. "I think one of the evolving thoughts is maybe what you do in the previous three months really affects what happens in the fall," Sheth says. If your doctor agrees that you can try skipping a refill, he'll very likely want to monitor you closely to head off trouble.
—January W. Payne