More than half of children diagnosed with asthma may not really suffer from the chronic respiratory disease, according to a recent study. Researchers from the University Medical Centre in Utrecht have attributed this over-diagnosis to the lack of adequate clinical tests carried out by doctors, and highlighted the dangers of children taking unnecessary medicines.
This rate would mean several thousands of British children and their families are unaware they are following the wrong treatment. The consequences of being wrongly diagnosed can go further. Side effects of unnecessary medicines can include muscle cramps, throat infections, tremors, vomiting and nausea – and affect also a child’s way of life, usually avoiding exercise and increasing the likelihood to being overweight.
While there are clinical methods to accurately determine if respiratory issues are due to asthma, the research published in the British Journal of General Practice shows that almost one in four times doctors diagnose the disease based just on symptoms. The problem is that these ailments, usually breathing trouble and persistent coughing, are common symptoms of many other conditions. From the 656 asthma diagnoses researchers took from four health centres in The Netherlands only 16% had been confirmed by a spirometer – to measure how much air one can breathe out in one forced breath.
“Only in a few children was the diagnosis of asthma confirmed using lung function tests, despite this being recommended in international guidelines,” Dr Ingrid Looijmans-van den Akker, one of the scientists behind the Dutch research, told The Daily Telegraph newspaper. “Over-diagnosis gives rise to over-prescription and incorrect use of medication, and to anxiety in parents and children.”
The British National Institute of Clinical Excellence (Nice) is using the research to support a new guideline they are expected to release later this year. “We are developing a guideline to provide advice for primary, secondary and community care healthcare professionals on the most suitable tests for accurately diagnosing asthma and how to help people monitor and control their symptoms,” says Professor Mark Baker, director of clinical practice at Nice.
Dr Maureen Baker, Chair of the Royal College of GPs, says: “Some useful diagnostic tests are already available in primary care in the UK, but we need increased investment so that we can broaden GP access to this equipment and undergo the training necessary to use it in the best interests of our patients.”
The NHS currently spends around £1bn a year on the 5.4 million apparent asthma patients in the country. Maybe, if the study’s findings are accurate, half this money is unnecessarily and ineffectively spent on people who are not actually ill, whilst the money could be invested in improving treatment of actual sufferers of the chronic disease.
