18 OPINION
The HEALTH | May-June. 2026
hood of future attacks and mortality. Repeated use of corticosteroids( oral steroids), often necessary in poorly controlled cases, can result in complications such as osteoporosis, adrenal suppression, weight gain and metabolic disturbances.
BREATHING BURDEN: A child using an inhaler at home highlights the emotional, physical and financial burden poorly controlled asthma places on families
Asthma ' s hidden toll
• Poorly controlled asthma can affect every aspect of a family ' s daily life and wellbeing.
• Families face significant medical costs from clinic visits, emergency care and hospitalisations.
• With early diagnosis, proper treatment and strong support systems, asthma can be effectively controlled.
ASTHMA is a chronic inflammatory lung disease marked by airway inflammation, narrowing, and hyperresponsiveness. In Malaysia, more than 1.4 million adults and almost half a million children aged 6 to 17 years have been diagnosed with asthma. with asthma. Despite the availability of effective treatments, asthma control remains suboptimal in many cases. The consequences extend well beyond clinical symptoms, placing a significant emotional, psychological and financial burden on families.
The unpredictability of asthma exacerbations creates a persistent state of stress within households. For caregivers, especially parents of children with asthma, this uncertainty often translates to chronic anxiety. Night-time symptoms disrupt sleep for both patients and family members, leading to fatigue, reduced productivity, and diminished quality of life.
Children with poorly controlled asthma may experience social and developmental challenges. Fear of triggering symptoms may limit participation in physical activities, while visible inhaler use or recurrent symptoms can lead to stigma.
Over time, these factors may contribute to
DR SULAIMANN TINT SOE LWIN
Dr Sulaimann Tint Soe Lwin is a Senior Lecturer at the School of Medicine, Faculty of Health and Medical Sciences, Taylor ' s University reduced self-confidence and emotional stress. Among adults, persistent symptoms and activity limitations have been associated with frustration, anxiety, and depression, further compounding the overall burden.
BROADER IMPACT ON FAMILIES
The financial implications are equally significant. Direct medical costs include frequent visits to primary care clinics and emergency departments, as well as hospital admissions.
Indirect costs are often even more substantial but less visible. These include transportation expenses, out-of-pocket medication costs, and lost income from missed workdays. Children with uncontrolled asthma are more likely to miss school and experience impaired academic performance, exacerbated by poor sleep quality and reduced concentration.
Adults, meanwhile, may remain in the workforce but perform below capacity, leading to reduced productivity and broader economic implications.
Beyond immediate impacts, poorly controlled asthma carries long-term health risks. Persistent inflammation can distort the structure of the airways and lead to an irreversible decline in lung function.
Severe exacerbations increase the likeli-
GAPS IN DIAGNOSIS
A critical yet underappreciated issue is diagnostic inaccuracy. Studies suggest that up to 20-70 % of actual asthma cases remain undiagnosed, particularly in primary care and low-resource settings, where access to spirometry – a breathing test that measures lung function – is limited.
At the same time, up to one-third of individuals diagnosed with asthma may not have the condition when reassessed objectively. Both underdiagnosis and misdiagnosis contribute to prolonged symptoms, inappropriate treatment, and increased healthcare utilisation.
Early and accurate diagnosis using objective tools such as spirometry is therefore essential.
Effective management hinges on adherence to maintenance therapy, particularly inhaled corticosteroids( ICS), which significantly reduce exacerbations, hospitalisations, and mortality. Yet adherence remains a major challenge, often due to misconceptions about side effects, poor understanding of the disease, or incorrect inhaler technique.
This is where patient education and system-level support play a vital role. Written asthma action plans, proper inhaler training, and trigger awareness have been shown to improve outcomes and reduce emergency visits. In Malaysia, primary care clinics( Klinik Kesihatan) play a central role in providing ongoing monitoring and education.
School-based programmes can equip teachers to recognise and respond to asthma symptoms, reducing risks during school hours. Pharmacists and community health workers can reinforce adherence through counselling and regular follow-up.
At the population level, smoking cessation and air quality improvements are essential, as smoking and pollution remain key triggers in Malaysia. Evidence from regional studies suggests that such coordinated efforts improve asthma control while reducing healthcare utilisation.
With proper early diagnosis, consistent adherence to evidence-based treatment, and stronger community and healthcare support systems, asthma can be effectively controlled. When managed well, it should not limit patients ' or their families ' quality of life.- The HEALTH