ASTHMA IN ADOLESCENTS AND YOUNG-ADULTS - SCREENING OUTCOME VERSUS DIAGNOSIS IN GENERAL-PRACTICE

The objectives of this study were to investigate underdiagnosis of ast hma in adolescents and young adults in general practice and to examine the influence of patient characteristics. The results of screening on asthma (questionnaire, spirometry) were compared with the diagnosis m ade in general practice. Screening results served as the reference sta ndard. Four general practices forming the Continuous Morbidity Registr ation, Nijmegen were used. Five-hundred and fifty-one subjects aged 10 -23, registered since their birth till the year of the study (1989) on the practice lists of these practices were involved in the study. The data collected included: (i) all episodes of respiratory morbidity in their life presented in general practice; (ii) socioeconomic level an d family history of asthma; and (iii) current respiratory status, alle rgy to inhalant allergens and smoking behaviour (questionnaire, spirom etry, histamine-challenge test and Phadiatop-test). The screening iden tified asthma in 19% of the study subjects, of whom 56% not had been r ecognized in general practice. Of the asthmatics recognized in general practice, significantly more were boys, had presented acute bronchiti s in the last 5 years preceding this study and had a family history of asthma than those not recognized. Of the latter, 30% had not presente d any respiratory disease in the last 5 years to their general practit ioner (GP). This study suggests underdiagnosis of asthma in adolescent s and young adults. Asthmatics are more likely to be recognized by the ir GPs in case of male sex, previous diagnosis of acute bronchitis and a family history of asthma. Reluctance of some patients to consult th eir doctor and low perception of symptoms may play a role in underdiag nosis.