Increase in diagnosed asthma but not in symptoms in the European Community Respiratory Health Survey

Trends in primary care consultations for asthma in Switzerland, 1989–2002

“…The European Community Respiratory Health Survey found a large increase in the reported use of medications for asthma over the past decade. 11 Our findings of a fall in subsequent asthma consultations are compatible with the hypothesis that management of asthma has changed, although formal selfmanagement plans with regular physician review are not widely implemented in Switzerland, even amongst wellmotivated patients. 32 In our study, subsequent consultation rates increased in 5-to 16-year olds from 1998 to 2001, consistent with the finding that the highest rates of emergency visits to general practitioners for asthma are in children.…”

“…This apparent discrepancy is interpreted as being attributable to a change in diagnostic labelling, with milder symptoms being labelled as asthma, 11,25,26 but could also indicate a true decline in underlying prevalence. 25 A recent fall in newly diagnosed cases of asthma, as reported here, might also reflect this trend, and is not incompatible with rising lifetime prevalence, particularly, for chronic conditions with low mortality such as asthma.…”

“…8,9 A long-standing concern is that, in the absence of an accepted objectively determined definition of asthma, these trends might have been influenced by changes in diagnostic labelling practices among doctors 10 or in symptom awareness by patients. 11 In Switzerland primary health care is delivered principally by general practitioners, general internists, and paediatricians. The Swiss Sentinel Surveillance Network (SSSN) has been collecting information about primary care consultations with physicians from these groups since 1986.…”

The Availability, Pricing and Affordability of Three Essential Asthma Medicines in 52 Low- and Middle-Income Countries

“…Although asthma cannot be cured, it can be managed effectively if patients have access to regular medicine [13][14][15][16][17]. Global concern about high levels of unnecessary morbidity and mortality associated with this condition, as well as the economic impact on health systems when asthma goes untreated, indicates the importance of exploring medicine pricing and ensuring availability of essential asthma medicines in developing countries [18][19][20].…”

Identifying asthma in population studies: from single entity to a multi-component approach

“…However, it does not overcome the difficulties that are inherent in making a clinical diagnosis in the first place, as described previously. Furthermore, to these problems, it adds potential errors in recall of the diagnosis among survey participants and variability among health professionals in their propensity to use the label asthma [20][21][22][23][24].…”