Identifying asthma and chronic obstructive pulmonary disease in patients with persistent cough presenting to general practitioners: descriptive study

Abstract

Objective: To determine the prevalence of asthma and chronic obstructive pulmonary disease in patients not known to have these disorders, who present in general practice with persistent cough, and to ascertain criteria to help general practitioners in diagnosis. Design: Descriptive study. Setting: Primary healthcare centre in the Netherlands.

Accuracy of symptoms, signs, and C-reactive protein for early chronic obstructive pulmonary disease

“…Based on the literature, 11 and clinical reasoning, the following symptoms and signs with potential value to detect early COPD were evaluated: age, 12 16 allergy for pollen, house dust mites, cats, or dogs, 6 diminished breath sounds, 17 and wheezing on auscultation.…”

“…Cough, age, sex, dyspnoea, pack-years of smoking, wheezing (auscultated and reported), and consultation for wheezing or cough were associated with COPD in primary 6,12,15 and secondary care 13,17,27,28 studies, and diminished breath sounds in secondary care studies. 14,17,29 Some reported diagnostic items were not included in the present analysis, including forced expiratory time, 27,28,30 laryngeal height, 13 peak flow, 17,27 and subxyphoid apical impulse, 4 because they are not incorporated in standard physical examination.…”

Undetected chronic obstructive pulmonary disease and asthma in people over 50 years with persistent cough

“…Until now, only one study has assessed the prevalence of both COPD and asthma in patients who consult their GP with coughing complaints. 11 However, the mean age of the patients in the Thiadens et al study was relatively low (44 years), while primary care studies suggest that underdiagnosis is more prominent in middle-aged and older individuals. [1][2][3] The aim of the present study was to determine the prevalence of undetected COPD and asthma in middle-aged and older patients who consult their GP for complaints of persistent cough.…”

“…11 In this study by Thiadens et al, 74 of the 192 participants had asthma (39%) and 14 had COPD (7%). The lower mean age of the participants of that study was probably the main cause for the high prevalence of asthma and the low prevalence of COPD, compared to the present results.…”

Mortality in Asthma-Chronic Obstructive Pulmonary Disease Overlap in the United States

“…[427][428][429] These questionnaires are usually context-specific, so they are not necessarily relevant to all countries (where risk factors and comorbid diseases differ), to all practice settings and uses (population screening versus primary or secondary care), or to all groups of patients (case-finding versus self-presenting with respiratory symptoms versus referred consultation). Examples of these questionnaires are provided on both the GINA and GOLD websites.…”