The need for pre-treatment spirometry in suspected asthma

Nicola J. Roberts, Rachel Haffenden, Martyn R Partridge

    Research output: Contribution to conferencePoster

    Abstract

    Background: The symptoms of asthma are not unique to that condition. In cases of suspected asthma objective corroboration of variable airway narrowing should be obtained. How often this is done in UK primary care, and with what results, is unclear.
    Methods: The records of 100 patients referred to a community respiratory assessment unit (1) with ²suspected asthma² were examined to determine the results of spirometry and treatment history.
    Results: Of 100 patients with suspected asthma [39M 61F, 46.7yrs (SD17.6)], 72 had no evidence of airway narrowing. 5 had a restrictive defect probably due to obesity (mean BMI 37.7). 13/100 had a diagnosis of asthma confirmed (airways narrowing and reversibility), 15 had airway narrowing but no demonstrable reversibility, 67 had no airway narrowing. In the latter two groups totalling 82 patients, 43 had been prescribed a short acting beta agonist, 18 an inhaled steroid and 2 an ICS/LABA combination. It is thus possible that in 20 patients prior use of anti inflammatory therapy was the reason for no demonstration of either airway narrowing or reversibility. 43 patients in whom a diagnosis could not been confirmed had been prescribed SABAs.
    Conclusions: Referral of patients with suspected asthma for spirometry led to confirmation of that diagnosis in only 13% of cases. In a further 20 cases the failure to confirm the diagnosis may reflect prior use of preventative therapies. An attempt at objective corroboration of diagnosis should be made prior to therapy, but spirometry may need to be repeated or additional investigations undertaken if a diagnosis of asthma is to be confirmed.
    Original languageEnglish
    Publication statusPublished - Oct 2008

    Keywords

    • asthma
    • spirometry
    • diagnosis
    • patient survey

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