April 12, 2014

Diagnosis of Asthma in Primary Health Care: A Pilot Study

Journal of Allergy
Volume 2014 (2014), Article ID 898965, 8 pages
http://dx.doi.org/10.1155/2014/898965
Clinical Study
1Nordic School of Public Health, 402 42 Gothenburg, Sweden
2Sahlgrenska Academy, University of Gothenburg, 413 90 Gothenburg, Sweden
3Kungsten Health Care Centre, 414 74 Gothenburg, Sweden
Received 6 September 2013; Revised 5 March 2014; Accepted 16 March 2014; Published 10 April 2014
Academic Editor: Steven Nordin
Copyright © 2014 Karin C. Ringsberg et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Some patients with an asthma diagnosis have a poor controlled asthma. One explanation may be an incorrect diagnosis. Aim. The aim of the study was to diagnose and classify patients with non-infectious lower respiratory tract problems in primary health care using internationally applied diagnostic criteria and diagnostic tests. 
Patients and Methods. New adult patients visiting a primary health care centre due to lower airway problems were included. The diagnostic tests included FEV1, FVC, PEF, two questionnaires, methacholine test, and skin prick test. 
Results. The patients () could be divided into four groups: asthma (28%), asthma-like disorder (44%), idiopathic cough (12%), and a nonreversible bronchial obstructive group (16%). The asthma and asthma-like groups showed similar patterns of airway symptoms and trigger factors, not significantly separated by a special questionnaire. Phlegm, heavy breathing, chest pressure/pain, cough, and wheezing were the most common symptoms. Physical exercise and scents were the dominating trigger factors. 
Conclusions. Nonobstructive asthma-like symptoms seem to be as common as bronchial asthma in primary health care. Due to the similarities in symptoms and trigger factors the study supports the hypothesis that asthma and nonobstructive asthma-like disorders are integrated in the same “asthma syndrome,” including different mechanisms, not only bronchial obstruction.

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