distinguishing asthma and COPD
Last reviewed 02/2021
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.