The level of diagnostic assessment in severe asthma: A nationwide real-life study

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  • Anna von Bulow, Københavns Universitet
  • ,
  • Vibeke Backer, Københavns Universitet
  • ,
  • Uffe Bodtger, Roskilde Hosp, Dept Resp & Internal Med
  • ,
  • Niels Ulrik Soes-Petersen, Roskilde Hosp, Dept Resp & Internal Med
  • ,
  • Karin Dahl Assing, Aalborg Univ Hosp, Aalborg University, Dept Resp Med
  • ,
  • Tina Skjold
  • Celeste Porsbjerg, Københavns Universitet

Introduction: Systematic assessment of patients with severe asthma is pivotal to decide which patients are eligible to new biological therapies. However, the level of diagnostic work -up in patients with severe asthma is only poorly investigated.

Aims & objectives: To describe the diagnostic work -up in a complete population of patients with severe asthma including: objective confirmation of the asthma diagnosis, and identification of potential treatment barriers, such as poor adherence and poor inhaler technique.

Methods: A retrospective cross-sectional multicenter study was performed in 2013. We evaluated patient record forms of all patients (aged 18-65 years) consecutively referred with asthma to one of five respiratory outpatient clinics over two years. Patients were included in the study, if they fulfilled ERS/ATS guidelines for having severe asthma.

Results: Among 1563 patients with asthma, 98 (6.3%) patients fulfilled the criteria for having severe asthma. The diagnosis of asthma was confirmed objectively in 53/98 patients (54.1%). In total, 83.7% underwent at least one diagnostic test for asthma: reversibility test: 63.3%, PEF: 52% and bronchial challenge test: 21.4%. Among patients eligible for a bronchial challenge test (FEV1 > 70%; negative PEF measurement/reversibility test), only 23.1% had such a test performed. Inhalation technique and adherence were assessed in 19.4 and 30.6% of patients, respectively.

Conclusion: Among patients managed for severe asthma in a specialist setting, only half had the asthma diagnosis confirmed objectively, and adherence and inhaler technique were infrequently assessed. (C) 2017 Elsevier Ltd. All rights reserved.

TidsskriftRespiratory Medicine
Sider (fra-til)21-29
Antal sider9
StatusUdgivet - mar. 2017

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