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19-11-2012 | Article

Acute cough should raise asthma alarm


Ann Fam Med 2012; 10: 523–529

Around one-fifth of patients consulting their GP for acute cough could have undiagnosed asthma or COPD, suggest the results of a European study.

"Cough is among the most common conditions for which people seek health care, and family physicians could help their patients by considering underlying asthma or COPD when their patients consult them for acute cough," say Dr Lidewij Broekhuizen (Julius Center for Health Sciences and Primary Care, Utrecht, the Netherlands) and colleagues.

The study was conducted at 16 centers across 12 European countries, including two UK primary care networks. In all, 1947 patients were included who presented to their GP with acute cough (≤28 days duration) but had not previously been diagnosed with asthma or COPD.

Overall, 12% of patients responded to salbutamol 400 mg (an increase in FEV1 of at least 12% or more than 200 mL) and reported experiencing more than one other episode of wheezing, cough, or chest tightness in the previous year.

Furthermore, airway obstruction was diagnosed in 10% of patients using the GOLD (Global Initiative for Chronic Obstructive Lung Disease) classification of an FEV1:FVC ratio of less than 0.7. It was diagnosed in fewer patients (6%) when obstruction was defined by the lower limit of normal based on age and gender.

"Although these findings are necessary but not sufficient to diagnose COPD and asthma, patients with these findings are at higher risk of having (yet undetected) chronic obstructive lung disease and might benefit from ongoing treatment," conclude Broekhuizen and colleagues in the Annals of Family Medicine.

GP News is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Kirsty Oswald