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Asthma
Underdiagnosed In
Better Educated People
NEW
YORK (Reuters Health) - The risk of underdiagnosis and undertreatment
of asthma is at least twice as high for individuals with higher
levels of education as for people with less education, according
to a report in the April issue of the Journal of Asthma.
Earlier studies
found no link between socioeconomic status and asthma diagnosis
rates, the authors explain, but poverty has been associated with
more severe symptoms and a greater likelihood of undertreatment.
Dr. Abdulbari
Bener from UAE University in Al-Ain, United Arab Emirates, and
colleagues used a patient questionnaire and medical records to
study the relationship between educational level and asthma diagnosis
and management at five primary healthcare centers in Al-Ain.
One patient
in six (16.8%) had asthma, the investigators found, and the prevalence
did not vary with education level.
Doctors failed
to diagnose asthma in nearly two thirds of these patients, the
researchers note, and a missed diagnosis was more likely among
those with a high level of education (77.6% missed) than among
those with a low level of education (34.6% missed).
Individuals
with asthma fared somewhat better in recognizing their conditions,
the report indicates. Only 41.7% of asthmatics did not know they
had asthma, but again the more-educated patients proved less informed
(53.4% did not know they had asthma) than the less-educated patients
(only 15% did not know).
Lack of knowledge
translated into undertreatment, as only 8.3% of all asthmatics
were taking prophylactic medication for asthma (3% of those with
higher education, 19% of those with lower education), according
to the report.
``The findings
of an increase in the rate of underdiagnosis and undertreatment
with increased level of patient education were unexpected,'' Bener
and colleagues write.
``The factors
that might be associated with these findings need to be explored
in further studies,'' the authors conclude.
SOURCE:
Journal of Asthma 2001;38:121-126.
Reference
Source 89
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