The prevalence of breathing pattern disorders in a tertiary paediatric severe asthma clinic.

<bold>Introduction:</bold> Breathing pattern disorders (BPD) can co-exist in patients with an asthma diagnosis and are recognised as contributory factors associated with worse asthma control. The importance of BPD is increasingly appreciated, although the prevalence within this population remains unclear. The Nijmegen questionnaire (NQ) is utilised to screen for BPD. An alternative approach is a structured assessment completed by a specialist physiotherapist (PT). We aimed to identify the prevalence of BPD within a paediatric severe asthma population, and to compare the prevalence of BPD as determined by the NQ with a PT assessment. Method: CYP aged between 10-17 years, attending a tertiary paediatric severe asthma clinic during 2022-2023 underwent a structured multi-disciplinary team evaluation in line with recommended national standards. As part of this evaluation, they completed a structured PT assessment for BPD. Participants also completed a NQ. <bold>Results:</bold> 60 CYP completed both a structured PT assessment and the NQ. The prevalence of BPD as assessed using the NQ was 23/60 (38%). The prevalence of BPD as determined by a PT assessment was 41/60 (68%). The sensitivity of the NQ when assessed against a PT assessment was 0.54, and specificity 0.95. <bold>Conclusions:</bold> This is the first study to examine the prevalence of BPD in a paediatric severe asthma clinic. The prevalence as determined by using a NQ is comparable to similar studies completed in adult severe asthma clinics. The NQ may underestimate the true prevalence of BPD when compared with a PT assessment but does appear to be specific. PT is an integral part in the management of this cohort and should be an essential part of the paediatric asthma MDT.