Child asthma missed by lung function test

GPs should use a beneficial response to medication test instead of lung function to diagnose asthma in pre-school children.

Chairman of the General Practice Airways Group (GPIAG) and Somerset GP Dr Steve Holmes, said: ‘Taking a good history of the child and testing for a beneficial response to medication are the main treatments used by GPs to successfully diagnose asthma in young children.’

A marked improvement of symptoms and recurrence of asthma when the treatment with medication is stopped is supportive of an asthma diagnosis.

However, diagnosing asthma  in pre-school children remains one of the most common problem areas in asthma treatment, said Dr Holmes.

‘It is important to pick up the condition as early as possible but not to overtreat because a lot of children will present with wheeze,’ he said.

This follows concerns that pre-school children with asthma risk are not being diagnosed if the diagnosis is based on lung function measurements.

Soren Pedersen, professor of paediatric respiratory medicine at the University of Denmark, raised concerns over using lung function measurements to identify variable airflow obstruction.

In his editorial in the Primary Care Respiratory Journal Professor Pedersen, said: ‘Although an individual child may be able to produce an occasional, reliable peak expiratory flow rate, the majority will not be able to do so with sufficient reproducibility over time to ensure that measured variability is caused by variable airflow obstruction, rather than lack of consistency.’

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