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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Abstract

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
Pages (from-to)45
Number of pages8
JournalPrimary Care Respiratory Medicine
Volume30
Issue number1
DOIs
Publication statusPublished - 2020

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