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distinguishing asthma and COPD
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Distinguishing COPD form asthma is mostly carried out on the basis of patient history and examination. The following features should be used to differentiate the two conditions whenever possible (1):
| COPD | Asthma | |
| smoker or ex-smoker | nearly all | Possibly |
| symptoms under age of 35 | rare | often |
| chronic productive cough | common | uncommon |
| breathlessness | persistent and progressive | variable |
| night time waking with breathlessness and/or wheeze | uncommon | common |
| significant diurnal or day to day variability of symptoms | uncommon | common |
In case of a diagnostic doubt the following can be done to differentiate between the two conditions:
- serial domiciliary peak flow measurements
- shows a 20% or greater diurnal or day-to-day variability
- reversibility test using bronchodilators and corticosteroids can be used
to separate asthma patients from those with COPD.
- a large (> 400 ml) response to bronchodilators
- a large (> 400 ml) response to 30 mg oral prednisolone daily for 2 weeks
Reference:
- 1. National Institute for Health and Clinical Excellence (NICE) 2010. Chronic obstructive pulmonary disease: Management of chronic obstructive pulmonary disease in adults in primary and secondary care.
Last reviewed 11/2019
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