Asthma, affecting approximately 300 million people worldwide, is an inheritable chronic respiratory condition where reversible narrowing of the airways in the lungs occurs. The airways get inflamed upon exposure to certain allergens.

A condition that is becoming increasingly common in Southeast Asia, it affects close to 15% of Singapore’s adult population, and approximately 4.2% of Malaysians. Though there is no cure, symptoms of asthma can be managed with the use of inhalers.

Different colours for different functions

However, when it comes to inhaler cases, colour serves a greater function beyond just looking pretty – different coloured cases indicate different kinds of drugs.

The blue inhaler is known as the reliever inhaler, for immediate rescue when one is experiencing symptoms of an asthma attack, such as chest tightness or shortness of breath. It contains a drug that quickly relaxes the muscles around the airways, allowing them to open up and make it easier to breathe for instant relief of symptoms.

On the other hand, the brown inhaler is used merely to help manage symptoms and help prevent further attacks. It contains a low dose of steroids which help reduce the sensitivity of airways.

When used regularly, it helps build up resistance to asthmatic triggers over time, decreasing the likelihood of attacks. Evidently, using the wrong one can mean the difference between life and death for asthmatics.

Company under fire for prioritising style over treatment

Inhal’Colors, the company in question, is developing a colourful range of inhaler covers for users to match their inhalers with “their look and lifestyle”.

Dr Keir Alexander Shiels, a paediatrician for the Royal College Of Paediatrics and Child Health (RCPCH), brought the public’s attention on this issue when he took to social media to express his disapproval of the idea, saying it was “very dangerous”.

“Specific drugs are specific colours,” he explained. “And we talk to patients in the language of blue, purple and brown.”

According to the Inhal Colors website, the inhaler cases are available in at least five colours (blue, pink, purple, black, and yellow, with interchangeable caps), but will only be compatible with Ventolin capsules, which are traditionally found in blue inhalers. The cases do not seem to be available yet, but a form is available on the website, enabling people to sign up to be alerted when they are.

Patients and doctors share disapproval in unison

Inhaler users appear to concur with Dr. Shiels’ tweet. “Looking cool is never my priority when reaching for my inhaler,” said one in response to the tweet.

“I agree: it’s brown and blue for me. Too many other things to think about than brown meaning purple and blue meaning yellow,” agreed another. Another person added: “Yup, terrible idea, I only knew to bring mum the blue or brown one on request.”

Many medical professionals have echoed Dr. Shiels’ concerns over the potential repercussions of straying away from the traditional colours used for different inhalers.

According to Dr Duncan Keeley, GP and policy lead for the Primary Care Respiratory Society UK, “With so many different compounds in inhalers, and patients often having more than one inhaler, referring to inhalers by their colour is obviously very helpful. And it also helps the people around the patient to know that the blue inhaler is the one that needs to be used in an emergency.

“So this is about safety – in a real emergency, when someone is struggling for breath, it is important that there is no room for confusion about which inhaler will have a rapid effect to relieve symptoms.”

Indeed, a survey conducted in November by the UK Inhaler Group (UKIG) revealed that 89% of patients and 95% of healthcare professionals frequently refer to the colour when discussing reliever medication.

The implication is clear: patients’ lives can be put at risk if pharmaceutical companies do not abide by the widely-recognised colour-coding of various inhalers for asthma. As such, there are calls for inhalers to have an official colour-code system to prevent any possible confusion over which inhaler to use in emergencies.

Company aware of issue

In response to the criticism, a spokesperson for Inhal Colors said, “We are aware of this issue, the treatment identification is indeed very important to avoid a dangerous confusion. We are very familiar with asthma because we are asthmatics and we believe that function and design can coexist.

“Our product (for relievers only) - which is not on [the] market - will not cure asthma. But whether or not we improve the motion of the inhaling gesture, or add a simple touch of colour to patients’ daily lives, each small improvement we make will act as a stepping-stone to improving our relationship with this disease.”

As the product is still in development, the company said it would work “directly with patients to answer their questions and queries”. MIMS

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