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Non-asthma visits predict risk of asthma attacks, research shows

GPs should be aware of patients with asthma visiting their practice often with non asthma-related health problems, as they could be most at risk of an asthma attack, say researchers.

An analysis published in the Primary Care Respiratory Journal looked at 166 patients with asthma diagnosed at a semi-rural GP clinic in south-west England and prescribed inhaled steroids, with their symptoms, non asthma-related visits and exacerbations recorded over five years.

Researchers found asthma exacerbations correlated with non asthma-related visits, severe asthma and with prescription-based adherence, and concluded that two non asthma-related visits per year to a GP could be treated as an indicator of risk of exacerbations.

They also suggested clinicians need to be aware of their patient's non asthma-related health problems, particularly those relating to psychological disturbance, musculoskeletal and gastric problems as well as sinusitis, as patients who reported these additional symptoms were at a greater risk of exacerbations.

The authors said: ‘We believe we have identified a simple tool that will help GPs identify and target resources for at-risk patients.

‘Our results suggest that a focus on medication adherence and severity alone misses an important factor that affects asthma outcome. The "dysregulated" or dysfunctional patient with multiple non-specific health problems is – particularly when non-adherent – the most at risk and more likely to benefit from educational interventions.'

But the authors did acknowledge their study could not reveal exactly the reason behind the relationship between non asthma-related visits and exacerbations, and suggested a larger sample would provide a better description of the non-asthma characteristics of the high exacerbator.

Primary Care Respiratory Journal 2012, online 26 July