Lung disease diagnosis confusion

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Most GPs have difficulty telling apart chronic severe lung disease from asthma, a survey finds.

Experts are warning chronic obstructive pulmonary disease (COPD) and asthma patients may have to be re-tested.

The finding from a poll of 776 UK GPs by the British Lung Foundation coincides with an audit which finds COPD care in England often falls short.

COPD, an umbrella term including chronic bronchitis and emphysema, is the fifth biggest killer in the UK.

The survey found that 80% of doctors found differentiating between asthma and COPD quite or very challenging.

The study also identified that one in 10 GPs did not have staff who had been trained to carry out or interpret the necessary tests.

The BLF is calling for everyone over 35 with asthma or COPD to be retested.

Dr Keith Prowse, of the BLF, said: "It can be difficult to differentiate between an asthma and COPD diagnosis but the long term aims of asthma and COPD treatment are different and it is vital that people with either disease have an accurate diagnosis.

"In asthma, the aim is to restore full lung function. If it is not treated properly the inflammation can cause scarring in the lungs and permanent damage.

"In COPD the management of the disease is quite complex and treatments such as pulmonary rehabilitation are crucial."

Audit

The National COPD Audit 2008 was carried out by National COPD Resources and Outcomes Project (NCROP), backed by the Royal College of Physicians (RCP), the British Thoracic Society and the British Lung Foundation (BLF).

The research found treatment of chronic obstructive pulmonary disease (COPD) had improved since 2005 - but was still patchy across the country.

It found evidence of a significant increase in provision of early discharge schemes, and of some treatments, such as non-invasive ventilation.

There are still great variations in the quality of care offered to COPD patients throughout the UK Dame Helena ShoveltonBritish Lung Foundation

The study concluded that staffing in many units was still below that recommended by the RCP. Information given to patients was seriously lacking, and provision of palliative care services was highly variable.

In addition, only a minority of units fully audit the services they provide - making it difficult to assess the quality of their COPD care.

Dr Robert Stone, of the British Thoracic Society said improvements in the availability of some services was "excellent news."

But he added: "It is clear there remains much to be done to ensure the quality of these services is consistent across the UK."

Dame Helena Shovelton, of the British Lung Foundation, said: "There are still great variations in the quality of care offered to COPD patients throughout the UK.

"Patients tell us that this causes them unnecessary distress and emergency hospital admissions which could be prevented through better information, support and earlier diagnosis."

The government in England is due to publish a national strategy for COPD next year.