Asthma or COPD? An investigation into the symptom patterns of asthma may highlight the need for more rigorous diagnostic procedures in elderly patients

Citation

Hoskins G, McCowan C, Thomas GE, Neville RG, Clark RA & Smith B (2001) Asthma or COPD? An investigation into the symptom patterns of asthma may highlight the need for more rigorous diagnostic procedures in elderly patients. Primary Care Respiratory Journal, 10 (4), pp. 99-102. http://www.thepcrj.org/journ/index.php?volissue=18

Abstract
Aim: To investigate the symptom patterns of elderly patients registered as active asthmatics. Method: An observational study using a database of 393 practices from throughout the United Kingdom. Participating practices provided health-service resource-use and symptom data for 30 randomly selected asthma patients. 8,244 adults, (16+ years), were stratified into three age groups, 4315(52%) aged 16-44, 2339(28%) 45-64, and 1590(19%) 65+. Comparisons were made for management and outcome measures (attack incidence, symptoms, health service resource use, drug therapies) between the groups. Results: Patients over 64 years old experienced more morning and exercise symptoms(p less than 0.001) and had more hospital admissions(p less than 0.001). They received higher levels of medication(p less than 0.001), were more compliant(p less than 0.001), but had poorer inhaler technique(p less than 0.001). Conclusion: Despite higher medication levels, 1,164(73%) patients over 64 years reported symptoms, 430(37%) of these, daily. For older patients, where regular symptoms are present despite high medication levels, investigation for diagnoses other than asthma should be routine.

Journal
Primary Care Respiratory Journal: Volume 10, Issue 4