Underdiagnosis of asthma and COPD: is the general practitioner to blame?

摘要: This paper analyses, on the basis of a series general practice studies, under-diagnosis asthma and chronic obstructive pulmonary disease (COPD) in terms magnitude problem, implications factors that contribute to adequate diagnosis. Most patients with or persistent respiratory signs/symptoms present practitioner (GP) it is GP who usually responsible for diagnosis treatment. An inherent problem 'early' COPD signs symptoms experience must be followed over time establish their chronic-recurrent nature. approach fits well--in itself--with principle continuity care. The analysis was mainly based "Diagnosis, Intervention Monitoring Asthma (DIM-CA)" study investigated hypothesis early intervention would enhance effectiveness (inhaled corticosteroid) intervention, this reason required detection as stage asthma/COPD possible. Despite fact are being diagnosed more frequently, proportion undiagnosed cases has remained stable years, pointing an increase prevalence population. A major factor symptoms, but do not these physician. Reluctance appears related reluctance take role patient (inhaled) medication. points patient-perceptions and--values important under-diagnosis. finding all relevant light increasing indications value For GPs primary care findings important. They imply will only possible when case-finding approach, evaluates pro-active outcome signs/symptoms, combined patients' perceptions values.