Bronchial provocation testing and self-care

An increase in the prevalence of asthma and asthma-related problems was widely noted both in Finland and abroad at the end of the 1960s. Consequently asthma became an everyday matter for pulmonologists. The Pikonlinna lung clinic set out to improve the diagnostics and treatment of lung asthma and other allergic lung diseases under the leadership of chief physician dr. Antero Muittari. In the 1970s specific bronchial provocation tests were introduced in Pikonlinna to identify the etiology of asthma together with non-specific bronchial provocation tests to measure the irritability of the bronchi. The exploration of work-related asthma began at the same time; chief specialist of the Pikonlinna lung clinic dr. Paula Hahtola was renowned for her expertise and contributions in the field. At the beginning of the 1980s asthma was by far the most common diagnose in the Pikonlinna’s lung clinic.

The dramatic improvements of medical treatment for asthma began in the 1960s. Several significant research projects were launched in the 1970s that were related to the pharmacology of asthma (a field of science that studies the influence of medical drugs on the human organs and vice versa, as well as the physiology and biochemistry of organs to an extent that is relevant for understanding of the influence of medical drugs), after which the treatment outcomes of asthma started to improve significantly. From this time onwards the Pikonlinna lung clinic was one of the most active developers of medical treatment for asthma in Finland. The year 1974 witnessed the development of inhalable cortisone products, which effectively suppressed inflammation in the bronchi.

The increasing number of asthma patients and patient compliance problems led to the development of guided self-care for asthma in the 1990s. This was a new treatment strategy in which asthma patients monitored at home their lung functions and the level of symptoms with the aid of a peak flow meter. They then self-adjusted their asthma medication according to detailed instructions in order to avoid the necessity of acute hospital treatment periods due to deterioration of asthma. Studies in the guided self-care for asthma were initiated in the 1990s under the leadership of the Pikonlinna lung clinic, whose favourable results attracted worldwide attention and which still constitute a sort of cornerstone for numerous treatment guidelines for asthma in Finland and abroad. Research and treatment of asthma continue to play a major role in the activities of the current pulmonology department even today.