Has the management of asthma improved?

Asthma morbidity and mortality are reported to be rising in the UK, despite increased sales of anti-asthmatic drugs. To determine whether recent advances in therapy have been beneficial the results of the 1970-71 and 1981-82 national morbidity surveys in general practice and the Department of Health and Social Security surveys of prescribing for 1968 to 1985 have been examined. Between 1970-71 and 1981-82 the number of asthmatics diagnosed rose by 75%, but, for the average asthmatic, consultation, home visit, and outpatients referral rates fell significantly by 19%, 44%, and 32%, respectively. Over the same period total prescribing for airflow obstruction rose by 76%. The proportion of treatment aimed at attack prevention increased from 10.6% to 19.4%. Thus for the average asthmatic management has improved because fewer consultations are required. Increased use of inhaled topical steroids and sodium cromoglycate is probably responsible for this improvement. Nevertheless preventive treatment remains under-prescribed and asthma is still underdiagnosed.