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Approach to the diagnosis and management of suspected exercise-induced bronchoconstriction by primary care physicians.

Hull, James H., Hull, Peter J., Parsons, Jonathan P., Dickinson, John W., Ansley, Les (2009) Approach to the diagnosis and management of suspected exercise-induced bronchoconstriction by primary care physicians. BMC Pulmonary Medicine, 9 . Article No. 29. ISSN 1471-2466. (doi:10.1186/1471-2466-9-29) (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided) (KAR id:43902)

The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided. (Contact us about this Publication)
Official URL
http://dx.doi.org/10.1186/1471-2466-9-29

Abstract

BACKGROUND

Exercise-related respiratory symptoms in the diagnosis of exercise-induced bronchoconstriction (EIB) have poor predictive value. The aim of this study was to evaluate how athletes presenting with these symptoms are diagnosed and managed in primary care.

METHODS

An electronic survey was distributed to a random selection of family practitioners in England. The survey was designed to assess the frequency with which family practitioners encounter adults with exercise-related respiratory symptoms and how they would approach diagnostic work-up and management. The survey also evaluated awareness of and access to diagnostic tests in this setting and general knowledge of prescribing asthma treatments to competitive athletes.

RESULTS

257 family practitioners completed the online survey. One-third of respondents indicated they encountered individuals with this problem at a frequency of more than one case per month. Over two-thirds of family practitioners chose investigation as an initial management strategy, while one-quarter would initiate treatment based on clinical information alone. PEFR pre- and post-exercise was the most commonly selected test for investigation (44%), followed by resting spirometry pre- and post-bronchodilator (35%). Short-acting beta2-agonists were the most frequently selected choice of treatment indicated by respondents (90%).

CONCLUSION

Family practitioners encounter individuals with exercise-related respiratory symptoms commonly and although objective testing is often employed in diagnostic work-up, the tests most frequently utilised are not the most accurate for diagnosis of EIB. This diagnostic approach may be dictated by the reported lack of access to more precise testing methods, or may reflect a lack of dissemination or awareness of current evidence. Overall the findings have implications both for the management and hence welfare of athletes presenting with this problem to family practitioners and also for the competitive athletes requiring therapeutic use exemption.

Item Type: Article
DOI/Identification number: 10.1186/1471-2466-9-29
Subjects: R Medicine > RC Internal medicine > RC1200 Sports medicine
Divisions: Divisions > Division of Natural Sciences > School of Sport and Exercise Sciences
Depositing User: John Dickinson
Date Deposited: 27 Nov 2014 12:44 UTC
Last Modified: 16 Feb 2021 12:56 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/43902 (The current URI for this page, for reference purposes)
Dickinson, John W.: https://orcid.org/0000-0002-1824-7402
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