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GPs to trial new tests for asthma amid concerns about overdiagnosis GPs to trial new tests for asthma amid concerns about overdiagnosis
(35 minutes later)
GPs are to test a new approach to diagnosing asthma following concerns that many people being treated for the condition do not have it.GPs are to test a new approach to diagnosing asthma following concerns that many people being treated for the condition do not have it.
The body that determines good practice for clinicians in England, the National Institute for Health and Care Excellence (Nice), has already told doctors they must back up their suspicions from patients’ symptoms with objective tests before making any diagnosis.The body that determines good practice for clinicians in England, the National Institute for Health and Care Excellence (Nice), has already told doctors they must back up their suspicions from patients’ symptoms with objective tests before making any diagnosis.
Now it wants to see whether the tests – measuring how much and how fast a person breathes using a spirometer – should routinely be backed up by other tests for any patient over five years old, including measuring levels of nitric oxide a patient is breathing out.Now it wants to see whether the tests – measuring how much and how fast a person breathes using a spirometer – should routinely be backed up by other tests for any patient over five years old, including measuring levels of nitric oxide a patient is breathing out.
The GP trials will help determine new guidance on diagnosing and treating asthma for England next year. Across the UK, care for about 5.4 million people with the condition costs the NHS about £1bn a year.The GP trials will help determine new guidance on diagnosing and treating asthma for England next year. Across the UK, care for about 5.4 million people with the condition costs the NHS about £1bn a year.
Related: More than 1m people in UK may have been wrongly diagnosed with asthmaRelated: More than 1m people in UK may have been wrongly diagnosed with asthma
Nice warned last year that up to 30% of people diagnosed with asthma did not show clear evidence of the condition, while a study of 650 children conducted in the Netherlands and reported in the British Journal of General Practice on Friday suggested half those diagnosed with the condition were unlikely to have had it. Only a few had had lung function tests. Nice warned last year that up to 30% of people diagnosed with asthma did not show clear evidence of having the condition, while a study of 650 children conducted in the Netherlands and reported in the British Journal of General Practice on Friday suggested half those diagnosed with the condition were unlikely to have had it. Only a few had had lung function tests.
But Asthma UK warned parents of children with an asthma diagnosis or currently going through the diagnosis process not to stop giving them their medicine on the basis of the Dutch study, without talking to their doctor. It said the Netherlands, where the “small” research had taken place, was a country with a very different health system.But Asthma UK warned parents of children with an asthma diagnosis or currently going through the diagnosis process not to stop giving them their medicine on the basis of the Dutch study, without talking to their doctor. It said the Netherlands, where the “small” research had taken place, was a country with a very different health system.
The use of spirometers for checking breath flow is commonplace, but nitric oxide checks tend to be used only in specialist asthma clinics. There will be an initial outlay for equipment and mouthpieces for these new tests, but Nice believes the overall cost per test, including the time of GP practice nurses, will be £13.66.The use of spirometers for checking breath flow is commonplace, but nitric oxide checks tend to be used only in specialist asthma clinics. There will be an initial outlay for equipment and mouthpieces for these new tests, but Nice believes the overall cost per test, including the time of GP practice nurses, will be £13.66.
Volunteer GP surgeries will be prepared for the trials of a battery of assessments which will run from May to October, although the Royal College of GPs has already warned that extra funding will be needed to implement any new strategy that may result across the country. Volunteer GP surgeries will be prepared for the trials of a battery of assessments, which will run from May to October, although the Royal College of GPs has already warned that extra funding will be needed to implement any new strategy that may result across the country.
Maureen Baker, who chairs the RCGP, said there was no one test that could definitively diagnose asthma, causing difficulties for GPs, particularly when some common symptoms were similar to those of other illnesses.Maureen Baker, who chairs the RCGP, said there was no one test that could definitively diagnose asthma, causing difficulties for GPs, particularly when some common symptoms were similar to those of other illnesses.
“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.”“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.”
Dan Murphy, director of external affairs at Asthma UK, said: “Asthma has many complex causes, which is why it is very difficult to get a definitive diagnosis. It is also a highly variable condition that can change throughout someone’s life or even week by week, meaning treatment also needs to change over time.Dan Murphy, director of external affairs at Asthma UK, said: “Asthma has many complex causes, which is why it is very difficult to get a definitive diagnosis. It is also a highly variable condition that can change throughout someone’s life or even week by week, meaning treatment also needs to change over time.
“The annual asthma review meeting is the bedrock of asthma care to ensure people with asthma get the right medication and know when to use it, and yet last year over 1 million people skipped this vital appointment.”“The annual asthma review meeting is the bedrock of asthma care to ensure people with asthma get the right medication and know when to use it, and yet last year over 1 million people skipped this vital appointment.”