7 April 2016

Inhalers are often dispensed for no good reason and are being treated like a “fashion accessory” argue respiratory doctors, who say the trivialisation of asthma is leading to child deaths.

Writing in the Archives of Disease in Childhood, they point out that after years of underdiagnosing asthma, the pendulum has swung too far in the opposite direction.

To back their claim of asthma overdiagnosis, they quote research from Australian respiratory physicians that shows half of children with chronic cough received an asthma diagnosis.

However, when investigated more intensively with bronchoscopy, the number of children thought to have asthma decreased.

Overdiagnosing asthma is a problem, insists Professor Andrew Bush and Dr Louise Fleming of Imperial College and Royal Brompton & Harefield NHS Foundation Trust, because side-effects from inhalers are more likely to occur in patients who are prescribed an inappropriate dose.

“Inhaled corticosteroids, when properly used, dramatically improve quality of life and reduce the risk of asthma attacks and mortality,” they write.

But there are potential side effects associated with their use. These include growth suppression and the dampening down of immune cell activity in the airways and the subsequent heightened risk of respiratory infections.

“There is also evidence that systemic absorption of [inhaled corticosteroids] depends not just on the prescribed dose, but is greater if the dose is inappropriately high for the degree of airway inflammation,” write the doctors.

The diagnosis of asthma has been trivialised, they say, and inhalers have become almost a fashion accessory.

“The result is the fact that asthma is a killing disease, if not correctly managed, is overlooked.”

Last Reviewed: 07/04/2016

Reproduced with kind permission from 6minutes.com.au.