One in three asthma sufferers may be misdiagnosed

AS many as 30 per cent of people diagnosed with asthma may not have it, NHS watchdogs have said, as they urge GPS to carry out “objective tests”.

New guidance from the National Institute for Health and Care Excellence (Nice) advises doctors to run spirometry and breath tests, to improve accuracy of diagnosis and treatment.

The guidance says better testing could avoid patients being needlessly prescribed medication and save the

NHS up to £15million a year.

Around 4.5 million people in England currently receive treatment for the inflammatory lung disease.

But research suggests that many of those regularly using inhalers in fact may have grown out of the condition – which is more common in children – or never had it.

The new NHS guidance advises GPS to carry out a series of tests to ensure that other conditions, such as allergies or other lung problems, are not mistaken for the inflammatory disease.

The guidance calls for a radical shift in the way asthma is diagnosed, relying far more on tests and less on descriptions of symptoms.

“Studies of adults diagnosed with asthma suggest that up to 30 per cent do not have clear evidence of asthma. Some may have had asthma in the past, but it is likely that many have been given an incorrect diagnosis,” the guidance says. Patients with suspected asthma should be given spirometry tests to measure lung function, and a type of breath test called a FENO test, which examines nitric oxide levels – an indicator of inflamed airways, it says.

Nice said areas should consider setting up asthma clinics to ensure the right expertise is in place.

It estimates that the NHS could save £10-£15 million over five years depending on how new services are set up – mainly through reducing unnecessary prescriptions. Dr Andrew Menziesgow, consultant in respiratory medicine at the Royal Brompton and Harefield NHS Foundation Trust and co-chairman of the guideline committee, said: “There is no ‘gold standard’ test that can give a definitive diagnosis. This can lead to people having treatments they may not need, or to a missed diagnosis in people who do have asthma.

“Our recommendations will help tackle inappropriate diagnosis and ensure that if a diagnosis is given, that the person is monitored to ensure their symptoms still indicate asthma.”

Kay Boycott, chief executive of Asthma UK, welcomed the guidelines, saying that three people die from an asthma attack each day.

“Doctors who suspect their patients have asthma are encouraged to trial treatment to see if symptoms improve before they diagnose someone. This is inefficient and wasteful as around 40 per cent of asthma patients do not respond to initial treatment,” he said.