JMIR Publications

ABSTRACT

Background:

Breathing pattern disorders (BPD) and inducible laryngeal obstruction (ILO) can cause similar symptoms to asthma, including dyspnoea and chest tightness. Both conditions can be comorbid with asthma, and there is evidence they are commonly misdiagnosed and mistreated as asthma.

Objective:

To explore whether symptoms of ILO and/or BPD were topics of discussion in a UK asthma online community, and explore patient experiences of diagnosis and treatment, in particular their use of reliever inhalers.

Methods:

A qualitative thematic analysis was carried out on posts from an asthma community between 2018 and 2022. Posts were identified using the key terms “blue inhaler” and “breath” and included in the analysis if describing one or more key symptoms of ILO or BPD. The list of key symptoms was based on available literature. The discussion threads of included posts were also analysed.

Results:

The search retrieved 1157 relevant posts. 58 were posted anonymously, and the remainder were written by 302 users. All participants were adults, except 2 parents posting about their children. Gender was stated by 5 participants (1.66%) (3 females and 2 males). Information on age was available from 30 participants (9.93%), who were between 27 and 73 years old, except for a 4-year-old discussed by their parent. The number of entries/participant ranged between 1 and 63, with the average being 3.54. Seven participants wrote >20 posts/each. Participants suffering from undiagnosed ILO or BPD symptoms, whether or not co-morbid with asthma, expressed frustration with the ‘one-size-fits-all’ approach of diagnosis, as many felt that their asthma diagnosis did not fully explain their symptoms. Others suspected or had formally been given a diagnosis of BPD or ILO, with the latter reporting relief of receiving a diagnosis and appropriate management. Participants described and showed awareness of their salbutamol overuse due to lack of effect on their symptoms. BPD and ILO symptoms emerged as frequently comorbid with asthma. The asthma online community was felt to be a valuable resource: engagement with the community not only brought comfort but also prompted action with some going back to their clinicians and reaching a diagnosis of ILO/BPD.

Conclusions:

Undiagnosed ILO and BPD and inappropriate use of salbutamol inhalers were topics of discussion in an asthma online community and caused distress and frustration to participants, affecting their relationship with healthcare professionals. There is need for further clinicians’ education on BPD and ILO diagnosis and management, as well as increased access to appropriate management options, such as respiratory physiotherapy, particularly in primary care. Online peer support from an established OHC could be a valuable resource for patients suffering from BPD/ILO. Clinical Trial: n/a