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Primary Care

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

BMJ 2001; 322 doi: (Published 05 May 2001) Cite this as: BMJ 2001;322:1098
  1. Mike Thomas (drmthomas{at}, general practitionera,
  2. R K McKinley, senior lecturerb,
  3. Elaine Freeman, primary care research coordinatorc,
  4. Chris Foy, medical statisticianc
  1. a Surgery, Minchinhampton, Stroud, Gloucestershire GL6 9JF
  2. b Department of General Practice and Primary Health Care, University of Leicester, Leicester LE5 4PW
  3. c Gloucestershire Research and Development Support Unit, Gloucestershire Health Authority, Gloucester GL1 2EL
  1. Correspondence to: M Thomas
  • Accepted 2 February 2001


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

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

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


  • Funding Royal College of General Practitioners Scientific Foundation Board. Minchampton surgery is a research and development practice funded under the NHS Executive South and West research and development general practice scheme.

  • Competing interests None declared.

  • Accepted 2 February 2001
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