Chances are you know a child with asthma; it's one of the most common chronic diseases in childhood, affecting 1.1 million children in the UK alone. However, new research suggests that up to half of those children may have been misdiagnosed. So that child you see coughing or wheezing may not have asthma at all. They may be suffering from other respiratory illnesses or allergies.
These findings come from a study undertaken by researchers in the Netherlands and published in the British Journal of General Practice. The researchers analysed data from four healthcare centres in Utrecht, looking at children aged 6 and over who were diagnosed with asthma or prescribed asthma medication. They found that 53.5% of the children were unlikely to have asthma. Another 23.2% had signs and symptoms in line with an asthma diagnosis, but should have undergone further lung function tests.
Out of all the cases, only 16.1% were diagnoses confirmed with spirometry, which uses a machine to measure how much and how fast a person breathes. Spirometry is recognised as the most accurate test for asthma, but most diagnoses in the study were made on based on children's symptoms alone.
These findings suggest that over-diagnosis may be more widespread than previously thought, and that many children may be taking medication for which they have no need. Families may be dealing with the anxiety caused by a long-term illness that their child does not actually have. Children may be holding themselves back from sports or other activities for fear of triggering a severe asthma attack that will never come.
The National Institute of Clinical Excellence (NICE) is in the process of creating new advisory guidelines for asthma diagnoses, recommending the frequent use of clinical tests. NICE has said that too many doctors are basing diagnoses on symptomatic histories instead of actual clinical tests, and that this new report will influence their policies around asthma.
Asthma UK, one of the UK's top asthma charities, issued a concerned response to the report, telling parents – "Don't stop your child's medicines." They encouraged parents to remember that the Netherlands report assessed a country whose healthcare system differs greatly from the NHS. It also only studied a relatively small group of children. They did acknowledge that improvements need to be made in asthma diagnosis, but also stressed the importance of continuing medication for children who have been diagnosed.
Asthma is a chronic respiratory disease that often starts in childhood. Symptoms include breathlessness, wheezing, tightness around the chest and coughing up of mucous, with the frequency and severity varying from person to person. The UK has some of the highest asthma prevalence and death rates in Europe. The NHS spends roughly £1 billion every year treating 5.4 million people with asthma, including 1.1 million children.
If you or one of your children suffer from Asthma you can purchase your regular asthma medication safely regularly from 121doc with common inhalers such as Ventolin.