Living well with asthma: How Nordic practices empower patients

For many people with asthma, a good day looks just like anyone else's – the ability to breathe normally, go for a run, and not worry about asthma.  

Living with asthma can be challenging and sometimes even unpredictable, and experiences vary from one person to another. Asthma is not a curable disease but with consistent treatment, symptoms can be managed, and the frequency of attacks reduced.   

While asthma affects people globally, some countries have taken innovative steps to manage it more effectively. National asthma and allergy programmes in Finland have shown how proactive management and lessening or preventing the causes which exacerbate asthma, help people live a normal life.^{1, 2}

The prevalence of asthma in adults in Finland is approximately 11%, so in the same level as elsewhere in Europe. However, asthmatics have significantly fewer symptoms than 20 years ago and increase in asthma prevalence is levelling off in Finnish adults.³

So, what can other countries learn from Finland's approach? 

Why education is the best medicine for asthma  

Asthma may be on the increase worldwide, but we know that improved management, increased understanding among both asthmatics and doctors, access to medicines, education, and better understanding have helped reduce morbidity and mortality.⁴  

In Finland, education has been a strong focus for health professionals, and asthmatics are encouraged to take advantage of guidance offered and be aware of how to manage their condition effectively.  

This includes training on how to use inhalers correctly and how to recognize and respond to symptoms if they get worse. The care plan may involve regular appointments with a nurse or doctor to review and adjust treatment plans.   

In comparison, in a survey of 15 general practices in Scotland, doctors were tested on their knowledge of guidelines relating to asthma.⁵ 98.4% were aware of the recommendation to offer education in self-management and written action plans for any asthma patient on their books. However, in practice, only 12.8% of practitioners provided such a plan.  

Rather than location, the answers appear to be in having a holistic attitude to maximize all options for a healthy life. 

Spreading the success story  

The results in Finland over the past 20 years should be encouraging to everyone. The right combination of medication, the desire to remain vigilant, to self-manage, and to be educated all help in achieving good days.  

Education is essential in helping people feel empowered. How else will they be able to take steps in making important lifestyle changes including stopping smoking and being more active? 

They need to know what questions to ask, and how to make these changes. A bond of trust can be developed between a person and their doctor through regular communication. A patient needs guidance in why they need to maintain a regular treatment regimen; what methods to try to give up smoking, to avoid passive smoke and what it means to maintain an active lifestyle. 

References:  

¹ Haahtela, T et al. The Finnish Allergy Programme 2008–2018 works. Eur Respir J 2017;49(6):1700470. https://erj.ersjournals.com/content/49/6/1700470 

² Haahtela, T et al. A ten-year asthma programme in Finland: major change for the better. Thorax 2006;61(8):663–70. https://pubmed.ncbi.nlm.nih.gov/16877690/ 

³ Hisinger-Mölkänen H et al. The increase of asthma prevalence has levelled off and symptoms decreased in adults during 20 years from 1996 to 2016 in Helsinki, Finland. Respir Med 2019;155;121–6. https://doi.org/10.1016/j.rmed.2019.07.014 

⁴ The Global Asthma Report (2018). http://globalasthmareport.org/2018/index.html(Accessed March 2023) 

⁵ Boulet LP. Asthma education: an essential component in asthma management. Eur Respir J. 2015;46(5):1262-4. https://pubmed.ncbi.nlm.nih.gov/26521279/