Asthma and chronic obstructive pulmonary disease (COPD) are the most common respiratory diseases routinely seen in primary care. In the UK, there are an estimated 8 million people with asthma, compared to approximately 1.2 million people with COPD. There are several clinical features that clearly distinguish them from one another (Table 1).1 Asthma is characterised by chronic inflammation and hyper-responsiveness of the airways, leading to variable airflow limitation.2 It is usually, but not always, diagnosed in childhood and patients typically experience intermittent wheeze, shortness of breath, chest tightness and cough, which improves either spontaneously or with treatment.3

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