The effects of Asthma in the UK and how diagnostics can help World Asthma Day - 6th May 2003 May 6th is World Asthma Day. Asthma can be life threatening but is also commonly seen as a manifestation of allergy where it can impact on the quality of life. The cost of asthma for primary and secondary care is considerable with developed economies spending 1-2 percent of their total health care expenditure on asthma. In addition to any healthcare costs there is a socio-economic burden relating to loss of work and schooling due to asthma. The prevalence is increasing annually and has been reported as having doubled in Western Europe during the past ten years. The major factors contributing to the morbidity and mortality of asthma are under diagnosis and inappropriate treatment. The burden of asthma for primary and secondary care is considerable – in 1999 there were approximately 74,000 hospital admissions due to asthma. The diagram below shows the effect on an average primary care organisation: 8 deaths 439 emergency admissions 25,100 receive treatment from GP 44,900 diagnosed with asthma 66,500 people with wheezing in the last year 330,000 patients in an average UK Primary Care Organisation In 1992/3 the European Community Respiratory Health Survey was performed using more than 10,000 young adults to look at asthma and allergic disease. A follow-up study is now underway using questionnaires, lung function tests and blood samples from the original participants to see how they have been affected over the last 9 years. The burden of asthma is not confined to cost but also has a severe effect on the quality of a sufferer’s life. Quality of life has been defined as “The functional effects of an illness and its consequent therapy upon a patient" (Schipper et al 1990) The role of In Vitro Diagnostics (IVDs): IVDs can help in early diagnosis of the cause of allergy. Once the cause or causes are established, the allergic individual can take steps to prevent or reduce exposure. Testing can be done by using either skin prick testing or by in vitro testing using a blood sample. Results obtained by in vitro testing compare well to skin prick testing. IVD testing is more convenient for both the patient and the clinician. Multiple tests can be performed on one blood sample and there are now tests available which provide results in the same time it takes to develop the reaction in skin prick testing. IVD testing also allows the level of Immunoglobulin E in the blood to be quantified (this is the substance produced in the body to counteract allergy) which allows the treatment to be monitored. Skin prick testing (SPT) is stressful for young children, and it cannot be performed on patients with skin disease (eg eczema) or with dark skin. SPT also relies on the tester’s individual skill at interpretating the response, the results can be affected if the patient is on certain medications (such as antihistamine) so IVD testing can be useful if the medication cannot be stopped because of the severity of the symptoms. The most common allergens causing asthma include house dust mite (70-80%), grass pollens (60%), cats (35-40%), dogs (30%) and moulds (5-10%). Allergic people are likely to be affected by more than one allergen. Early diagnosis is vital for alleviation of disease. • Allergic diseases represent the commonest chronic diseases managed within the community • These diseases are increasingly prevalent and carry considerable morbidity in addition to potential mortality • There is extremely poor provision for specialist services and inadequate training for community care • There is little government/establishment impetus for change despite the considerable health care burden of the allergic diseases and patient need • The early diagnosis would help early intervention and potential prevention of disease For further information please contact: Doris-Ann Williams, Director General, BIVDA, 1 Queen Anne’s Gate, London SW1H 9BT Tel: 020 7957 4633 Fax: 020 7957 4644 www.bivda.co.uk Editors notes: The British In Vitro Diagnostics Association (BIVDA) was established in London in February 1992 as the national trade association for companies with major involvement and interest in the In Vitro Diagnostics (IVD) industry. BIVDA represents the interests of the IVD industry in the UK at the European Diagnostics Manufacturers Association (EDMA), which in turn represents the IVD industry in Europe particularly at the Commission as the evolution to the Single Market progresses. The membership of BIVDA currently represents over 90% of the industry. For further information on asthma: www.asthma.org.uk/news/media02a.php Additional information can be found at the following web sites: Lab Tests Online: labtestsonline.org/understanding/analytes/allergy/test.html Global Initiative for Asthma: www.ginasthma.com European Federation of Allergy and Airways Diseases Patient’s Association (EFA): www.efanet.org References: 1. Statistics obtained from the National Asthma Campaign (Asthma J 2001)