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

Gaylor Hoskins; Colin McCowan; Giles E Thomas; Ronald G Neville; Roland A Clark; Barbara Smith

doi:10.1038/pcrj.2001.38

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

Prim Care Respir J. 2001 Dec;10(4):99-102. doi: 10.1038/pcrj.2001.38. Epub 2001 Dec 1.

Authors

Gaylor Hoskins, Colin McCowan, Giles E Thomas, Ronald G Neville, Roland A Clark, Barbara Smith

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<0.001) and had more hospital admissions(p<0.001). They received higher levels of medication(p<0.001), were more compliant(p<0.001), but had poorer inhaler technique(p<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.