Family Practice Vol. 9, No. 4, 397-404
© Oxford University Press 1992
other |
Does the Continuous Use of Bronchodilators Mask the Progression of Asthma or Chronic Bronchitis?
* From the Department of General Practice Nijmegen University PO Box 9101, 6500 HB Nijmegen, The Netherlands
** From the Department of Pulmonary Diseases, Nijmegen University PO Box 9101, 6500 HB Nijmegen, The Netherlands
To whom reprint requests should be sent
Recently, we published data of a 2 year randomized controlled study in which the effects of continuous versus symptomatic bronchodilator treatment in patients with moderate asthma or chronic bronchitis were investigated. The results showed that FEV1 decline in the continuously treated group was significantly larger than in the symptomatically treated group (72 versus 20 ml/year, P < 0.05). We reanalysed these data in order to investigate the hypothesis that the continuous use of bronchodilators may mask a rapid decline in lung function. Lung function decline was assessed by regression analysis of seven FEV1 measurements. Respiratory symptoms were assessed by means of the MRC questionnaire every 12 months, and they were also recorded by the patients in a weekly report. Of the participating patients 144 completed the study. Increased lung function decline in the continuously treated group was not reflected in a significant deterioration of the symptoms. Moreover, the decline in FEV1 showed no correlation at all with changes in respiratory symptoms in continuously treated patients (r = –0.03, P = 0.80), whereas in the symptomatically treated group, there was a better relation (r = –0.32, P = 0.003) to changes in respiratory symptoms. These results show that continuous bronchodilatation may indeed mask the worsening of the disease. This lack of awareness of deterioration of the disease is probably caused by the continuous symptom relief of bronchodilators. It may be misleading to both patients and physicians.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M Albers, T Schermer, Y Heijdra, J Molema, R Akkermans, and C van Weel Predictive value of lung function below the normal range and respiratory symptoms for progression of chronic obstructive pulmonary disease Thorax, March 1, 2008; 63(3): 201 - 207. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. R. Douma, H. A. M. Kerstjens, A. de Gooijer, S. E. Overbeek, G. H. Koeter, and D. S. Postma Initial Improvements in Lung Function and Bronchial Hyperresponsiveness Are Maintained During 5 Years of Treatment With Inhaled Beclomethasone Dipropionate and Terbutaline Chest, January 1, 2002; 121(1): 151 - 157. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C P van Schayck, F M M A van der Heijden, G van den Boom, P R S Tirimanna, and C L A van Herwaarden Underdiagnosis of asthma: is the doctor or the patient to blame? The DIMCA project Thorax, July 1, 2000; 55(7): 562 - 565. [Abstract] [Full Text]
|
|
|
|
 |
|
 J. BOUSQUET, P. K. JEFFERY, W. W. BUSSE, M. JOHNSON, and A. M. VIGNOLA Asthma . From Bronchoconstriction to Airways Inflammation and Remodeling Am. J. Respir. Crit. Care Med., May 1, 2000; 161(5): 1720 - 1745. [Full Text]
|
|
|
|
|
|
G. van den BOOM, C. P. van SCHAYCK, M. P. M. H. RUTTEN-van MOLKEN, P. R. S. TIRIMANNA, J. J. den OTTER, P. M. van GRUNSVEN, M. J. BUITENDIJK, C. L. A. van HERWAARDEN, and C. van WEEL Active Detection of Chronic Obstructive Pulmonary Disease and Asthma in the General Population . Results and Economic Consequences of the DIMCA Program Am. J. Respir. Crit. Care Med., December 1, 1998; 158(6): 1730 - 1738. [Abstract] [Full Text] [PDF]
|
|