Prs. Tirimanna et al., PREVALENCE OF ASTHMA AND COPD IN GENERAL-PRACTICE IN 1992 - HAS IT CHANGED SINCE 1977, British journal of general practice, 46(406), 1996, pp. 277-281
Background. Asthma and CORD are common diseases of the airways which a
re mainly diagnosed and treated in general practice. Aim. Various stud
ies have reported an increase in the morbidity of asthma and COPD. The
re are two possible reasons for such an increase. The first is an appa
rent increase caused by using different criteria in defining asthma/CO
PD, and by increased awareness of the disease by doctors and patients.
The second is a real increase caused by an increase in the prevalence
of airway pathology. The aim of this study was to determine the cause
of the observed increase in morbidity. Method. In 1977, a sample of 2
328 adults from the general population were screened for asthma and CO
PD. Those screened were then divided into five sub-groups (grades 1-5)
, according to severity of: (1) respiratory symptoms; and (2) loss in
FEV(1). The number of patients who were not known to the general pract
itioner prior to the screening as having asthma or CORD grades 1-5 wer
e also assessed. In 1992, we studied a different sample of 1184 adults
of the general population in the same area. We used the same criteria
as in 1977 to analyse our results. The number of patients not known t
o the general practitioner prior to the screening was also studied. Re
sults. The overall prevalence (grades 1-5) of asthma and CORD has incr
eased from +/- 19% in 1977 to +/- 31% in 1992 (range 27-42). The main
reason for this is an increase in prevalence of very mild to moderate
asthma and COPD (grades 1-3) from 17% in 1977 to 27% in 1992. The prev
alence of severe cases (grades 4-5) increased from 2% in 1977 to 4% in
1992. In 1992, around 65% of the patients were not known to the gener
al practitioner as having any grade of asthma or CORD. This was only s
lightly lower than the 72% in 1977. All patients with a severe disease
(grade 5) were known to the general practitioner. Conclusions. There
is a real increase in the prevalence of asthma and CORD, caused predom
inantly by an increase in the number of mild cases. The percentage of
patients not known to the GP were predominantly mild cases.