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Home arrow Information Papers arrow 1 Asthma and Allergy arrow Diagnosis History taking
Diagnosis – History Taking Print E-mail

As well as general questions about asthma symptoms, consider the following:

1 Atopy is strongly linked with asthma

  • Over 90% of children and 80% of adults with asthma are atopic.31, 32
  • The presence of eczema is a marker of more severe and/or persistent asthma.33, 34
  • Children still wheezing at 6 years are more likely to have a maternal history of asthma and elevated serum IgE levels.12
  • Sensitisation to house dust mite and the mould, Alternaria is associated with a high incidence of asthma.35, 36<LE I>

2 Rhinitis

Rhinitis of any cause is a risk factor for asthma (including allergic rhinitis).37, 38

3 Are allergens triggering asthma symptoms?

Timing of symptoms

  • Perennial (persistent) or seasonal (intermittent) symptoms.
  • Time of day, for example, allergy symptoms provoked by house dust mite are often worse at night and first thing in the morning.
  • Time of week, for example, if at weekends consider some activity such as horse-riding, or environment such as old dusty weekenders.

Occupation

  • Is there a slow improvement away from the workplace?
  • What potential allergen exposures are occurring at work?

Geographic associations of symptoms

  • Such as work, home or holidays.

Environmental descriptors

  • Conditions at home, such as house age, construction, ventilation, dampness, floor coverings, room clutter, bedding.
  • Soft toys in the bedroom.
  • Pets in the home.
  • Smoking history of family members.

When should referral to an allergy specialist be considered?

  • When there is evidence of continuing poor asthma control despite regular use of preventer medication or if there is regular use of bronchodilators.

  • When there are other allergic diseases.

  • When foods or food allergy are suspected as asthma triggers.

  • In cases of occupational allergy.

  • If immunotherapy is contemplated.

  • When patients express an interest in exploring allergy issues.

  • For further education regarding allergy issues of patient or family.

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Content Updated March 2005

 
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