I am grateful for the effort by Dr Tan Ngiap Chuan and his team in confirming a long observed phenomenon in primary care ("Night-time asthma attacks? Nose may be cause"; Wednesday).
I have faced difficulties in managing patients with such problems.
First, there is very little knowledge among the public of the links between the different sensitivity conditions.
Public health promotion needs to be more frequent and in-depth.
Primary care providers play a significant role here. For instance, GPs can spend a few extra minutes to explain the links and introduce preventive measures to patients.
Second, prevention is fundamental and important. For instance, the use of preventive inhalers and nasal sprays will help reduce symptoms and attacks.
However, many patients shun them because of "steroid phobia", forgetting that the consequence of not using them is far worse.
Other preventive measures include maintaining an allergen-free environment with air-conditioning and air purifiers, quitting smoking, looking after our pets well, wearing masks and vaccinating against flu viruses and pneumococcus bacteria.
Third, the public should be encouraged to self-medicate.
Many antihistamines are now available over the counter at the pharmacy. However, not many people are aware of this.
To improve accessibility, some of the antihistamines can be reclassified as general medicine. That way, the public can access them even when there is no pharmacist on duty or at places other than a pharmacy.
Fourth, GPs should review their patients at regular intervals. Studies have repeatedly shown that many asthma patients also suffer from obstructive sleep disorders; this, in turn, affects their blood pressure and cardiovascular system.
There are also studies suggesting that uncontrolled symptoms may lead to frequent infections and may damage the lungs in the long run.
The public must be educated about the importance of regular reviews. The money spent on reviews and preventive measures is most cost-efficient, compared with that spent on treatment. This is on top of intangible costs, such as emotional costs and the costs of absence from work.
Finally, the cost of prevention should be kept affordable. Insurance companies must not treat allergy sufferers as taboo.
They should not increase their premiums or exclude their conditions from coverage.
On the contrary, they should reward their clients for adopting preventive measures.
Leong Choon Kit (Dr)