The University of Southampton
University of Southampton Institutional Repository
Warning ePrints Soton is experiencing an issue with some file downloads not being available. We are working hard to fix this. Please bear with us.

A cross-sectional study of patterns of airway dysfunction, symptoms and morbidity in primary care asthma

A cross-sectional study of patterns of airway dysfunction, symptoms and morbidity in primary care asthma
A cross-sectional study of patterns of airway dysfunction, symptoms and morbidity in primary care asthma
Background: Most patients with asthma are managed exclusively in primary care. Little is known about the patterns of airway dysfunction in these patients and how these relate to other aspects of the disease.
Aims: We set out to assess this in a cross-sectional study of 262 patients.
Methods: Symptoms, spirometry, airway responsiveness, reversibility, and airway inflammation were all assessed. Exacerbations requiring oral corticosteroids in the preceding year were enumerated.
Results: Patients had heterogeneous patterns of airway dysfunction. Those with a post-bronchodilator forced expiratory volume in 1 sec/forced vital capacity ratio of <0.7 had more exacerbations in the previous year (2.2 vs. 0.8; mean difference 1.4; 95% CI 0.4 to 2.4;p=0.007). Patients with normal results had less inflammation (proportion with a sputum eosinophil count of >1.9%, 20% vs. 48%,?2=14.8, df=3; p<0.001) and fewer exacerbations (0.5 vs. 1.4; mean difference –0.9; 95% CI –1.4 to –0.4; p=0.001) but similar symptom scores (6.2 vs. 6.9; p=0.2) compared with patients with any abnormality.
Conclusions: Patients with a diagnosis of asthma have mixed patterns of physiological impairment; many have no airflow obstruction or airway hyper-responsiveness. The physiological characterisation of asthma is not related to symptoms and is of little value in predicting exacerbations or eosinophilic airway inflammation.
asthma, COPD, diagnosis, primary care
1471-4418
283-287
Shaw, Dominick
ccd4b59e-6012-466f-9de4-8b4dde635328
Green, Ruth
ab2c7aec-5030-44e7-9a18-3604b1873808
Berry, Mike
87c68a77-1b4e-466d-9bab-9a4ca6048a54
Mellor, Sarah
0242647c-9d2f-452c-9c57-7c16b3a97625
Hargadon, Beverley
4157aa31-e695-4e4a-9031-28fccaf9392f
Shelley, Maria
265f4ed8-cff7-4b93-8243-e76a451672b6
McKenna, Sue
d1c3824b-432f-4260-859c-9e492979ea2b
Thomas, Mike
997c78e0-3849-4ce8-b1bc-86ebbdee3953
Pavord, I
105d8c74-3448-4755-9894-623bfd9b1358
Shaw, Dominick
ccd4b59e-6012-466f-9de4-8b4dde635328
Green, Ruth
ab2c7aec-5030-44e7-9a18-3604b1873808
Berry, Mike
87c68a77-1b4e-466d-9bab-9a4ca6048a54
Mellor, Sarah
0242647c-9d2f-452c-9c57-7c16b3a97625
Hargadon, Beverley
4157aa31-e695-4e4a-9031-28fccaf9392f
Shelley, Maria
265f4ed8-cff7-4b93-8243-e76a451672b6
McKenna, Sue
d1c3824b-432f-4260-859c-9e492979ea2b
Thomas, Mike
997c78e0-3849-4ce8-b1bc-86ebbdee3953
Pavord, I
105d8c74-3448-4755-9894-623bfd9b1358

Shaw, Dominick, Green, Ruth, Berry, Mike, Mellor, Sarah, Hargadon, Beverley, Shelley, Maria, McKenna, Sue, Thomas, Mike and Pavord, I (2012) A cross-sectional study of patterns of airway dysfunction, symptoms and morbidity in primary care asthma. Primary Care Respiratory Journal, 21 (3), 283-287. (doi:10.4104/pcrj.2012.00057). (PMID:22786814)

Record type: Article

Abstract

Background: Most patients with asthma are managed exclusively in primary care. Little is known about the patterns of airway dysfunction in these patients and how these relate to other aspects of the disease.
Aims: We set out to assess this in a cross-sectional study of 262 patients.
Methods: Symptoms, spirometry, airway responsiveness, reversibility, and airway inflammation were all assessed. Exacerbations requiring oral corticosteroids in the preceding year were enumerated.
Results: Patients had heterogeneous patterns of airway dysfunction. Those with a post-bronchodilator forced expiratory volume in 1 sec/forced vital capacity ratio of <0.7 had more exacerbations in the previous year (2.2 vs. 0.8; mean difference 1.4; 95% CI 0.4 to 2.4;p=0.007). Patients with normal results had less inflammation (proportion with a sputum eosinophil count of >1.9%, 20% vs. 48%,?2=14.8, df=3; p<0.001) and fewer exacerbations (0.5 vs. 1.4; mean difference –0.9; 95% CI –1.4 to –0.4; p=0.001) but similar symptom scores (6.2 vs. 6.9; p=0.2) compared with patients with any abnormality.
Conclusions: Patients with a diagnosis of asthma have mixed patterns of physiological impairment; many have no airflow obstruction or airway hyper-responsiveness. The physiological characterisation of asthma is not related to symptoms and is of little value in predicting exacerbations or eosinophilic airway inflammation.

This record has no associated files available for download.

More information

e-pub ahead of print date: 11 July 2012
Published date: September 2012
Keywords: asthma, COPD, diagnosis, primary care
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 343341
URI: http://eprints.soton.ac.uk/id/eprint/343341
ISSN: 1471-4418
PURE UUID: 42c2a01f-65e2-4ada-a46b-edf9454f4953

Catalogue record

Date deposited: 03 Oct 2012 11:41
Last modified: 08 Nov 2021 23:12

Export record

Altmetrics

Contributors

Author: Dominick Shaw
Author: Ruth Green
Author: Mike Berry
Author: Sarah Mellor
Author: Beverley Hargadon
Author: Maria Shelley
Author: Sue McKenna
Author: Mike Thomas
Author: I Pavord

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×