EAACI Task Force Logograms: Asthma logogram to facilitate the diagnosis of asthma in primary care

AimAlthough Asthma is the most common chronic obstructive respiratory disease in primary care, the diagnosis continues to pose challenges. The aim of our Task Force is to reduce the diagnostic process of five common allergic problems encountered in primary care (asthma, anaphylaxis, food allergy, drug allergy and urticaria) to a bare minimum, in order to provide clarity and to facilitate the process to the many GPs who have little or no training in allergic disorders. This abstract focuses on the asthma logogram. MethodExisting documents/guidelines on the diagnosis of asthma were identified: mainly the GINA and ERS/ATS guidelines, supplemented with international and national guidelines and existing diagnostic tools in asthma. The resulting asthma logogram was based on a pragmatic primary care interpretation of existing guidelines. The asthma logogram evolved during five in depth interdisciplinary discussions with the whole Task Force group including GPs, allergy specialists, researchers and clinical fellows. ResultsThe asthma logogram consists of four steps: 1) Assessing probability of asthma (high, medium, low) based on known predictive and excluding factors. 2) Based on access to reversibility or variability lung function testing: assess lung function in high and medium probability. Consider other diagnosis in low probability. Without access to lung function testing: in high probability start ICS/LABA treatment. Refer to specialist care in medium probability or if no alternative diagnosis can be established in low probability. 3) Treat according to local asthma guidelines. 4) Evaluate in 2-4 weeks and confirm or reject diagnosis. ConclusionBased on existing guidelines, we developed a simple and pragmatic asthma logogram for primary care in order to support GPs in making a (provisional) allergy diagnosis. Further steps will be peer validation and computerization of the logograms. Ultimately, a trial should be undertaken to demonstrate and confirm the utility of the allergy logograms in primary care. This may in future facilitate improved integrated care in allergy and improvement of both patient outcomes and experience of services. Implementation Science/Service Development Research Ideas on Respiratory Conditions and Tobacco Dependency Abstract Declaration of Interest All authors declare no conflict of interest in relation to this abstract References and Clinical Trial Registry Information