Childhood asthma is the most common chronic disease in childhood, with a prevalence of 10.2% in 2018. However, there is evidence of over-and under diagnosis in about 30% in mixed populations of adults and children and young people (CYP). This is particularly problematic in pre-school children where there is difficultly carrying out objective testing. 

Over-diagnosis can lead to unnecessary medication costs and side effects, and a delay in making the real diagnosis. Under-diagnosis of asthma can lead to a delay in initiating effective asthma therapy with inhaled corticosteroids (ICS). Such delay can cause needless suffering, exacerbations of asthma and was considered a major factor as the cause of death in the National Review of Asthma Deaths (NRAD) in 2014. Timely and accurate diagnosis of asthma in CYP is therefore essential and a key element of the NHS Transformation Plan for CYP.

In this position statement we outline the background, key issues and PCRS position on diagnosis children and young people with asthma. As part of this, the Primary Care Respiratory Society (PCRS) provides key steps on how to make a firm diagnosis of asthma in this important group, as well as sharing that diagnosis with parents, carers and schools to ensure a well rounded, consistent and informed management of the condition.