Portugal Conducts First Clinically Validated National Asthma Survey in Over a Decade
Asthma in Portugal: How a New National Study Is Reshaping Diagnostics, Policy, and Market Opportunities
Asthma is one of the world’s most common chronic diseases, yet accurately measuring its impact remains a persistent challenge. In Portugal, a new national study—EPI-ASTHMA—is changing that narrative. For the first time in over a decade, researchers have delivered a clinically validated, nationwide estimate of adult asthma prevalence using methods that go far beyond traditional surveys.
This isn't just an epidemiological update. It’s a methodologically groundbreaking initiative with far-reaching implications—from public health policy and clinical practice to pharmaceutical investment and digital health innovation.
A Data-Driven Redefinition of Asthma Prevalence in Portugal
For years, national asthma estimates in Portugal were based primarily on self-reported surveys, prone to recall bias and underreporting. The EPI-ASTHMA study, conducted between 2021 and 2024 and recently published in Pulmonology, changes that with a rigorous, stepwise diagnostic approach that mirrors real-world clinical evaluation.
This dual-phase methodology began with large-scale telephone screening using the Adult Asthma Score (A2 Score)—a validated patient-reported tool with strong predictive power—and was followed by in-person diagnostic evaluations, including spirometry, fractional exhaled nitric oxide measurements, and eosinophil counts. The design aligned with GINA (Global Initiative for Asthma) standards, providing a high-fidelity picture of actual asthma prevalence.
Key finding: Adult asthma prevalence in Portugal stands at 7.1%, confirming stability since the last nationwide survey in 2010 despite a completely new diagnostic framework.
Why This Study Stands Out: Methodological Innovation and Clinical Relevance
1. Clinical Precision Meets Epidemiology
Unlike previous studies that relied solely on symptom questionnaires, EPI-ASTHMA integrates objective clinical tests with patient-reported outcomes. The A2 Score, in particular, emerged as a powerful screening tool—explaining up to 45% of variance in asthma diagnosis in predictive models.
This integration addresses a critical gap in global asthma epidemiology: the disconnect between how asthma is diagnosed in research versus in real clinical settings. EPI-ASTHMA bridges that divide.
2. Truly Representative Sampling
With data collected from across Portugal using stratified, multistage random sampling, the findings reflect national demographics by region, age, and sex. This eliminates the urban bias of earlier studies and allows for more precise health planning at both national and regional levels.
3. New Risk Factor Insights
The study confirmed several well-known risk factors—such as family history, allergic symptoms, and prior inhaler prescriptions—but also flagged education level as a key determinant. Adults with lower educational attainment had a significantly higher risk of asthma, underscoring persistent health inequities and the importance of tailored public health messaging.
Strategic Implications Across Sectors
For Public Health and Healthcare Providers
With approximately 700,000 adults in mainland Portugal affected by asthma, health authorities now have an updated, evidence-based foundation for allocating resources and designing interventions. Primary care practices can incorporate the A2 Score into routine screening, enabling earlier diagnosis and better disease management—particularly in underserved populations.
For Pharmaceutical and Diagnostic Industries
This study offers clarity for pharmaceutical companies targeting respiratory diseases. The prevalence rate, validated diagnostic pathway, and confirmed risk factors define a measurable market segment for new therapies and medical devices. It also highlights opportunities for digital health solutions, such as app-based versions of the A2 Score, integrated with home spirometry or wearable monitoring devices.
For Policymakers and Investors
The robust data set generated by EPI-ASTHMA empowers evidence-based policymaking. Initiatives aimed at reducing environmental triggers, improving indoor air quality, or enhancing education around respiratory health can now be more precisely targeted. Investors eyeing the digital health and medtech space should note the scalable potential of validated screening tools like the A2 Score across other EU nations and Portuguese-speaking countries.
Broader Academic and International Relevance
Academically, EPI-ASTHMA raises the bar for respiratory epidemiology. Its comprehensive, mixed-methods approach provides a template for similar studies in other countries—particularly those seeking to replace legacy survey techniques with clinically anchored diagnostics. Moreover, the dataset offers opportunities for secondary analysis, such as identifying asthma phenotypes or studying regional environmental risk factors.
From a global perspective, Portugal now joins a select group of countries with modern, clinically validated asthma prevalence data. This facilitates international benchmarking and comparative research that can drive broader shifts in how asthma is diagnosed and managed worldwide.
A New Standard for Asthma Surveillance—and a Wake-Up Call
The EPI-ASTHMA study represents more than just a methodological upgrade—it’s a recalibration of how nations should track chronic disease prevalence in the 21st century. With asthma affecting millions globally, the model demonstrated in Portugal offers a clear path forward: combine clinical realism with population-scale data collection, and use the results to inform action—not just academia.
For clinicians, policymakers, and investors alike, this study is a call to rethink how we measure, manage, and monetize health. The next question is: Who’s going to adopt this model next?