The use of a direct bronchial challenge test in primary care to diagnose asthma

J E Bins, E I Metting, J B Muilwijk-Kroes, J W H Kocks*, J C C M In 't Veen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Many asthmatics in primary care have mild symptoms and lack airflow obstruction. If variable expiratory airflow limitation cannot be determined by spirometry or peak expiratory flow, despite a history of respiratory symptoms, a positive bronchial challenge test (BCT) can confirm the diagnosis of asthma. However, BCT is traditionally performed in secondary care. In this observational real-life study, we retrospectively analyze 5-year data of a primary care diagnostic center carrying out BCT by histamine provocation. In total, 998 primary care patients aged ≥16 years underwent BCT, without any adverse events reported. To explore diagnostic accuracy, we examine 584 patients with a high pretest probability of asthma. Fifty-seven percent of these patients have a positive BCT result and can be accurately diagnosed with asthma. Our real-life data show BCT is safe and feasible in a suitably equipped primary care diagnostic center. Furthermore, it could potentially reduce diagnostic referrals to secondary care.

Original languageEnglish
Article number45
Number of pages8
JournalPrimary Care Respiratory Medicine
Issue number1
Publication statusPublished - 16-Oct-2020

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