Diagnosis and management of childhood asthma in primary care

Abstract

Diagnosing asthma in children is challenging, but information obtained from clinical history and objective lung function testing should help nurses determine probability and adopt a stepwise approach, write Dr David Lo, Dr Brigitte Gaillard, Louise Bullous and Dr Erol Gaillard Although asthma is the most common non-communicable disease of childhood, there is no standardised definition nor gold-standard test available to diagnose the condition. Asthma is a complex airways disorder where genetic, environmental and host immunity are likely to play a part. Misdiagnosis in children is common, although objective lung function tests aid accuracy, when combined with a clinical history. Adopting a stepwise approach to achieving complete, or good, control of symptoms enhances management and regular treatment reviews should include provision of mutually-agreed, written personalised asthma action plans, which should also be given to children's schools. When control is poor or diagnosis uncertain, patients should be referred to specialist care.