Lifestyle changes in mild asthma during intermittent symptom-related use of terbutaline inhaled via ‘Turbohaler’

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Abstract
Beta2-agonist therapy effectively relieves asthmatic symptoms, but an improvement in patient lifestyle has not been demonstrated. This open study in which patients acted as their own controls, assessed the efficacy and acceptability of intermittent symptom-related use of terbutaline inhaled via ‘Turbohaler’, and its influence on the lifestyle of 1133 inhaler-naive, mild asthmatics treated in general practice. A 1-week run-in period was followed by 4-weeks' treatment with inhaled terbutaline (500 ng as required). Peak expiratory flow rate (PEFR) and ‘Turbohaler’ technique were assessed at clinic visits. Diary cards, completed daily, assessed: the number of terbutaline inhalations, the relief obtained after use, the severity of asthma symptoms (cough, morning wheeze, nocturnal wheeze and wheeze on activity), and lifestyle indices (sleep disturbance, work/school days lost, limitation of normal activity). After terbutaline treatment, PEFR increased by 54±2 1/min (p<0.001), the severity of asthma symptoms was almost halved (p<0.001), with over two-thirds (65% to 76%) of patients reporting improvements in each variable, and the adverse effect of asthma on lifestyle was at least halved (p16 years), school-age children (6 to 16 years) and preschool children (≤5 years). This study not only confirmed the efficacy and acceptability of intermittent symptom-related use of terbutaline inhaled via ‘Turbohaler’, but also demonstrated that its use enhanced patients' lifestyles.