BMJ 2001;322:1098-1100 ( 5 May )

Primary care

Prevalence of dysfunctional breathing in patients treated for asthma in primary care: cross sectional survey

Editorial by Keeley and Osman

Mike Thomas, general practitioner, ^a R K McKinley, senior lecturer, ^b Elaine Freeman, primary care research coordinator, ^c Chris Foy, medical statistician. ^c

^a Surgery, Minchinhampton, Stroud, Gloucestershire GL6 9JF, ^b Department of General Practice and Primary Health Care, University of Leicester, Leicester LE5 4PW, ^c Gloucestershire Research and Development Support Unit, Gloucestershire Health Authority, Gloucester GL1 2EL

Correspondence to: M Thomas drmthomas{at}oakridge.sol.co.uk

Objectives: To estimate the prevalence of dysfunctional breathing in adults with asthma treated in the community.
Design: Postal questionnaire survey using Nijmegen questionnaire.
Setting: One general practice with 7033 patients.
Participants: All adult patients aged 17-65 with diagnosed asthma who were receiving treatment.
Main outcome measure: Score 23 on Nijmegen questionnaire.
Results: 227/307 patients returned completed questionnaires; 219 (71.3%) questionnaires were suitable for analysis. 63 participants scored 23. Those scoring 23 were more likely to be female than male (46/132 (35%) v 17/87 (20%), P=0.016) and were younger (mean (SD) age 44.8 (14.7) v 49.0 (13.8, (P=0.05). Patients at different treatment steps of the British Thoracic Society asthma guidelines were affected equally.
Conclusions: About a third of women and a fifth of men had scores suggestive of dysfunctional breathing. Although further studies are needed to confirm the validity of this screening tool and these findings, these prevalences suggest scope for therapeutic intervention and may explain the anecdotal success of the Buteyko method of treating asthma.

What is already known on this topic Abnormal breathing patterns may cause characteristic symptoms and impair quality of life Effective interventions exist for dysfunctional breathing Dysfunctional breathing has been described in patients attending hospital respiratory clinics What this study adds 29% of adults treated for asthma in primary care had symptoms suggestive of dysfunctional breathing Affected patients were more likely to be female and younger, but no differences were found with severity of asthma Some patients with asthma may benefit from breathing therapy

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