Abstract
Epidemiological questionnaires have failed to identify individuals with severe asthma. The extent of symptoms of asthma can however easily be established in epidemiology, by identification of multiple symptoms. We hypothesise that reporting of multiple symptoms of asthma reflects uncontrolled disease, and is a sign of more severe asthma. The aims of the current study are therefore to determine the prevalence and determinants of multi-symptom asthma.
A postal questionnaire was sent to 30 000 randomly selected individuals aged 16–75. A subgroup underwent clinical examinations. Multi-symptom asthma was defined as reported physician-diagnosed asthma, use of asthma medication, recurrent wheeze, attacks of shortness of breath and at least one additional respiratory symptom.
The prevalence of multi-symptom asthma was 2.0% and was more common among females (2.4% vs. 1.5%, p<0.001) and in those with BMI >30. Multi-symptom asthmatics had lower FEV1% predicted, higher FeNO, and more pronounced hyperresponsiveness. Family history of both asthma and allergy (OR 7.3) and occupational exposure to gas dust or fumes (OR 2.0) were also significant risk factors.
Multi-symptom asthma comprises 2% of the general population, is related to signs of more severe disease, and could be used as an epidemiological marker of disease severity.
- ERS