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We need more investment in diagnostics for asthma

Recent headlines in national media have declared that asthma is ‘overdiagnosed and trivialised’. But as I am sure your readers know, these news stories are masking a deeper issue: there is no simple diagnostic test for asthma. It is shocking that in the 21st century we still do not have a simple test to be able to tell if someone has asthma, a condition so common that, on average, there are three pupils with asthma in each classroom in the UK. In fact, the UK has among the highest prevalence rates of asthma symptoms in children worldwide.

If you cannot be sure of a diagnosis, how can you give patients the right care or treatment they need to manage their condition? This is the challenge healthcare professionals face every day. But we also need to tackle the complacency that has set in around asthma, as the Royal College of Physicians identified in the National Review of Asthma Deaths (NRAD) in May 2014.

More than a million people missed their annual asthma review in 2015 and only 35% of people with asthma have a written asthma action plan, despite research showing that people who use one are four times less likely to be admitted to hospital because of their asthma. We all need to work together to tackle complacency and to stop people needlessly dying from preventable asthma attacks. People with asthma must work in partnership with their GP, nurse and pharmacist to build up a complete picture of their asthma, and ensure they are on the right treatment and follow a written asthma action plan.

In the longer term we need effective ways to diagnose people to enable to us to put the right people on the right treatments. An accurate diagnosis is the starting point from where we can get people on the right treatment, and then review and support their management over time. Without a diagnosis, there will always be the potential for people to be on the wrong treatment, possibly for many years, which could lead to poor outcomes and even avoidable deaths. More investment in new diagnostics for asthma is desperately needed to allow this ambition to become a reality.

Samantha Walker

Director of Research and Policy

Asthma UK


Citation: Clinical Pharmacist DOI: 10.1211/CP.2016.20201032

Readers' comments (1)

  • Another essential role for pharmacists to support best care in asthma is that of feeding back to prescribers when we suspect/know there are problems with adherence (unintentional/deliberate) or where we consider the management to be suboptimal (eg not following BTS/SIGN guidelines). While this may feel like a breach of patient confidentiality or undermine the professionalism of the prescriber, having attempted to address the issues with the patient directly, can you ethically continue to dispense inappropriately large numbers of SABA inhalers for example?

    The press were keen to describe the NRAD report under headlines proclaiming "unsafe prescribing", but how many of us would be guilty of perpetuating this through "unsafe dispensing"?

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