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

doi:10.1136/bmj.322.7294.1098

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 dysfunctionalbreathing in adults with asthma treated in thecommunity.
Design: Postal questionnaire survey using Nijmegenquestionnaire.
Setting: One general practice with 7033patients.
Participants: All adult patients aged 17-65 with diagnosedasthma who were receivingtreatment.
Main outcome measure: Score $>=$ 23 on Nijmegenquestionnaire.
Results: 227/307 patients returned completed questionnaires;219 (71.3%) questionnaires were suitable for analysis. 63 participantsscored $>=$ 23. Those scoring $>=$ 23 were more likely to be female thanmale (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 differenttreatment steps of the British Thoracic Society asthma guidelineswere affectedequally.
Conclusions: About a third of women and a fifth of menhad scores suggestive of dysfunctional breathing. Although furtherstudies are needed to confirm the validity of this screening tooland these findings, these prevalences suggest scope for therapeuticintervention and may explain the anecdotal success of the Buteykomethod of treatingasthma.

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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