PREVALENCE OF ASTHMA AND COPD IN GENERAL-PRACTICE IN 1992 - HAS IT CHANGED SINCE 1977

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.