ACCURACY OF PERCEPTION OF SEVERITY OF ASTHMA - PATIENTS TREATED IN GENERAL-PRACTICE

Objective-To determine the frequency of poor perception of severity of asthma in general practice. Design-Asthmatic patients recorded their perceived severity of asthma, with a visual analogue score, and a coded measurement of their peak expiratory flow up to four times daily for 14 consecutive days. Settings-11 general practices in and around Bristol. Subjects-255 asthmatic patients (139 men and 116 women) aged 17-76 who were recruited by random selection from the general practices' disease registers or when they requested prescriptions for inhaled bronchodilators. Main outcome measures-Correlation between visual analogue scores and peak expiratory flow (as a percentage of predicted peak flow). Results-152 (60%) of the patients showed no significant correlation between visual analogue asthma scores and simultaneous peak flow measurements (p>0.05) and were termed poor discriminators. The distribution of good and poor discriminators within each general practice was similar (chi2=6.11, df=10). The two groups were not characterised by differences in the maximum, minimum, or standard deviation of peak expiratory flow or visual analogue score; in age; or in the proportion of men and women in each group. Conclusion-In general practice a high proportion of asthmatic patients do not reliably detect changes in their lung function. This reinforces the need for careful objective assessment of lung function in the management of asthma.