Doctors can diagnose the severity of patients’ asthma with just a few simple questions.
When it comes to asthma, proper diagnosis of the severity of the disease is one of the biggest challenges facing patients and doctors.
A proper diagnosis is very important because it determines the various treatments the patients receive. A misdiagnosis can hurt doctors’ abilities to properly determine severity and control of asthma, and can often lead to improper treatments.
Part of this misdiagnosis is doctors not asking the right questions. Often, patients think they’re in control of their asthma simply because they haven’t gone to the emergency room. The National Heart, Lung and Blood Institute (NHLBI) provides a set of five questions all doctors should ask their asthma patients during checkups:
- Have you used prednisone or had flare-ups that caused you to go to the emergency room or an urgent care center?
- Have you been waking up at night because of interrupted breathing?
- Have you had symptoms during the day?
- How often do you use your albuterol inhaler?
- Do you have limitations on your exercise?
After asking those five questions, the doctor can get a better idea of what’s happening with the patient. But, if the doctor just asks, “Hey, how’s your asthma doing?” you often get an underestimation of the severity from the patient.
There are several factors that impact the diagnosis. Doctors are under tremendous pressure to see as many patients as possible during the day, which reduces time spent with the individual. Also, some physicians aren’t aware of the need to ask the NHLBI questions.
Primary care physicians have to deal with a variety of different diseases. Because of this, it’s hard for these doctors to follow all the guidelines for proper diagnosis and be knowledgeable on every aspect of the various diseases that come through their offices.
There are many treatment options on the horizon, but our current methods are not much different than how asthma has been treated for years. Albuterol is still the drug of choice for rescue and pre-exercise. Inhaled steroids are a drug of choice for maintenance.
Asthma appears to be part of a group of diseases that manifest similarly. Some patients are allergic, others are not allergic. Some only have symptoms when they have a common cold and others only when they exercise. In other cases weight loss can improve symptoms. In the future I suspect that we will treat different types of asthma differently, but at the present time therapies are very similar for the majority of patients with asthma.
Timothy Craig, DO, is Professor of Medicine and Pediatrics, Division of Pulmonary, Allergy and Critical Care, and Distinguished Educator at Pennsylvania State University, where he is also Chief of the Allergy/ Immunology Section, Director of Allergy and Respiratory Clinical Research as well as Allergy, Asthma and Immunology Program Director. Dr. Craig received his medical degree from the New York College of Osteopathic Medicine in 1984 and is a fellow of the American Academy of Allergy, Asthma and Immunology.