Ah. Kendrick et al., ACCURACY OF PERCEPTION OF SEVERITY OF ASTHMA - PATIENTS TREATED IN GENERAL-PRACTICE, BMJ. British medical journal, 307(6901), 1993, pp. 422-424
Objective-To determine the frequency of poor perception of severity of
asthma in general practice. Design-Asthmatic patients recorded their
perceived severity of asthma, with a visual analogue score, and a code
d measurement of their peak expiratory flow up to four times daily for
14 consecutive days. Settings-11 general practices in and around Bris
tol. Subjects-255 asthmatic patients (139 men and 116 women) aged 17-7
6 who were recruited by random selection from the general practices' d
isease registers or when they requested prescriptions for inhaled bron
chodilators. Main outcome measures-Correlation between visual analogue
scores and peak expiratory flow (as a percentage of predicted peak fl
ow). Results-152 (60%) of the patients showed no significant correlati
on between visual analogue asthma scores and simultaneous peak flow me
asurements (p>0.05) and were termed poor discriminators. The distribut
ion of good and poor discriminators within each general practice was s
imilar (chi2=6.11, df=10). The two groups were not characterised by di
fferences in the maximum, minimum, or standard deviation of peak expir
atory flow or visual analogue score; in age; or in the proportion of m
en and women in each group. Conclusion-In general practice a high prop
ortion of asthmatic patients do not reliably detect changes in their l
ung function. This reinforces the need for careful objective assessmen
t of lung function in the management of asthma.