Incorrect Diagnosis of Asthma in Children
A recent news report noted that many children are being incorrectly diagnosed with asthma. It found that inhalers were being dispensed when not strictly necessary.
Prof Andrew Bush and Dr Louise Fleming warn that although steroid inhalers are life-saving when used properly, their side-effects should not be ignored. Both experts believe a more careful diagnoses should be undertaken and dispensing inhalers should not be done lightly.
According to the Charity, Asthma UK
better tests are urgently needed. In the UK, about 5.4 million people currently receive treatment for asthma - 1.1 million of whom are children. The charity's Dr Samantha Walker said "It is astonishing in the 21st century that there isn't a test your child can take to tell if they definitely have asthma.
"Asthma isn't one condition but many, with different causes and triggered by different things at different ages. Asthma symptoms also change throughout someone's life or even week-by-week and day-by-day.
"This complexity means that it is both over and under-diagnosed, in children and in adults, so people don't get the care they need to manage their asthma effectively."
As a result, a child is admitted to hospital every 20 minutes because of an asthma attack and asthma attacks still kill the equivalent of a classroom of children every year in the UK."
Writing in the journal Archives of Disease in Childhood, the two respiratory doctors from Imperial College and the Royal Brompton Hospital in London acknowledge that asthma can be a fatal condition that was once not being diagnosed adequately.
They argue that the opposite is now happening resulting in some people seeing asthma as a trivial matter and overlooking the potential it has to kill.
Doctors currently use guidelines to help work out if someone has the condition but making a diagnosis can be difficult as there is no definitive test.
The article says doctors should think very carefully about each diagnosis they make and consider the use of more objective and sometimes more invasive checks for example by testing nitrogen oxide levels and blood tests.
If a child’s condition is not getting better despite asthma medication then, instead of increasing doses automatically, they ought to look at the possibility that the diagnosis might not be correct.
The paper also urges medical practitioners should bear in mind that many children may outgrow their symptoms and therefore there should be regular checks to ensure the medication prescribed is still relevant.
Prof Mark Baker of NICE said: "Accurate diagnosis of asthma has been a significant problem which means that people may be wrongly diagnosed or cases might be missed in others."
New National Institute for Health and Care Excellence (NICE)
guidelines for England, which are now out for consultation before final approval, say doctors should use more clinical tests to back up their judgement and avoid the danger of wrongly labelling someone as having asthma.“We deal with far too many cases of incorrect diagnosis and it is important to ensure any treatment provided is appropriate for the condition as medications prescribed have side effects and in some cases the outcome can be serious and indeed fatal” - Daxa Patel.