Asthma: Overdiagnosis in children sees inhalers dished out like ‘fashion accessories,’ claim health experts

Fears patients are being subjected to ‘hazardous’ side effects as a result of unnecessary treatment

The diagnosis of asthma has been 'trivialised', two leading respiratory doctors said (PA)

Inhalers are being dished out like “fashion accessories” according to health experts who warn that medics are over-diagnosing asthma in children.

Two leading respiratory doctors said diagnosis of the breathing condition has been “trivialised” and that patients are subjected to “hazardous” side effects as a result of unnecessary treatment.

Writing in the BMJ journal Archives of Disease in Childhood, the authors highlight a previous study in which half of 100 children with a chronic cough were told they had asthma. However, once the coughs were thoroughly investigated the number actually thought to have the condition dwindled to 5 per cent.

Professor Andrew Bush, from the Royal Brompton and Harefield NHS Foundation Trust, and Dr Louise Fleming of Imperial College London, said the National Review of Asthma Deaths highlights the need for correct diagnosis.

“It is an intensely depressing document which shows that no lessons have been learnt over the last 15 years, and children still die because of failures in basic management,” they said.

“We propose that one contributing factor is that the diagnosis of asthma has been trivialised and inhalers dispensed for no good reason, and have become almost a fashion accessory. The result is the fact that asthma is a killing disease, if not correctly managed, is overlooked.

“Is there any other chronic disease in the world in which children are committed to potentially hazardous, long-term therapy without every effort being made objectively to document the diagnosis?”

The authors outline various approaches to aid correct diagnosis, including the need to remember that many children outgrow asthma symptoms and that treatment should not simply be stepped up if the child fails to respond, because an incorrect diagnosis may have originally been made.

Dr Samantha Walker, Director of Research and Policy at Asthma UK, said the paper illustrates the challenges GPs face

“It’s astonishing in the 21st century that there isn’t a test your child can take to tell if they definitely have asthma,” she said. “Asthma isn’t one condition but many, with different causes and triggered by different things at different ages. Asthma symptoms also change throughout someone’s life or even week by week and day by day. This complexity means that it is both over and underdiagnosed, in children and in adults, so people don’t get the care they need to manage their asthma effectively.

“As a result, a child is admitted to hospital every 20 minutes because of an asthma attack and asthma attacks still kill the equivalent of a classroom of children every year in the UK. We urgently need more investment in asthma research to get to a definitive test to ensure people get the right diagnosis.”