Double check your asthma–you might not have it

By Marina Wang, Ottawa Bureau.

A new study found that 33% of Canadians recently diagnosed with asthma did not have an active form of the condition. The study was published in the Journal of the American Medical Association earlier this week. 701 participants were enlisted for the study conducted across Canada, between 2012 and 2016. The purpose of the study was to examine the remission rate and stability of asthma diagnoses.

Lead researcher and respirologist Shawn Aaron from the University of Ottawa said that the high proportion of patients not exhibiting the respiratory condition was due to both the asthma going into remission and initial misdiagnosis. “It’s a chronic disease, and it can go into remission and then ultimately relapse again” said Aaron.

Some patients were also misdiagnosed in the first place. Misdiagnoses can occur when a physician doesn’t order the right testing for asthma and makes a conclusion based solely on observing symptoms. Two percent of patients in the study had a different, serious respiratory condition that had been misdiagnosed as asthma. The study suggested that physicians should order objective tests to confirm asthma at the time of initial diagnosis.

80 percent of patients who no longer had asthma continued to take their medication, with over a third taking them on a daily basis. “I don’t want anyone to think that they should stop taking their medicine,” said Aaron, “but if you have been diagnosed with asthma and you’re on chronic medication, and you’re very well controlled– in other words you have no symptoms, you’re not short of breath, you’re not wheezing, you’re not coughing, it might be wise to go see your physician. Ask your physician to do a breathing test called a spirometry and potentially reassess your asthma.”

Spirometry is a test that examines lung function by measuring how much air can be inhaled and exhaled, and how quickly. It can be used to diagnose asthma or chronic obstructive pulmonary disease (COPD).

Aaron said that asthma medication is well tolerated in most patients, and consequences to overtreatment are largely economical. On average, asthma medication may cost between $1000 and $1200 per year. “If you’re taking medicine and paying for the medicine when you don’t need it, then you’re sort of wasting your money,” said Aaron.

Aaron said that short term side effects of asthma treatment can include a fungal mouth infection called oral thrush as well as easy bruising. Some medications can cause tremors, rapid heart rate, or anxiety. Long term side effects can include glaucoma, cataracts, and osteoporosis.

 

Aaron SD, Vandemheen KL, FitzGerald JM, Ainslie M, Gupta S, Lemière C, Field SK, McIvor RA, Hernandez P, Mayers I, Mulpuru S, Alvarez GG, Pakhale S, Mallick R, Boulet L, for the Canadian Respiratory Research Network. Reevaluation of Diagnosis in Adults With Physician-Diagnosed Asthma. JAMA. 2017;317(3):269-279. doi:10.1001/jama.2016.19627

[Photo Credit: Ben Dalton]

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