A lack of simple tests for common lung conditions is preventing GPs making accurate diagnoses, a charity says.
Asthma and Lung UK says it could cause serious problems for the NHS in winter, as respiratory viruses start to spread.
One in five people is affected at some point by chronic obstructive pulmonary disease, which includes emphysema and chronic bronchitis, or asthma.
Lung disease is the third biggest killer in the UK, behind cancer and heart disease.
Peak-flow and spirometry tests (when lung air flow is measured) or fractional exhaled nitric oxide (FeNo) tests (nitric oxide is measured as it is a biomarker for asthma which provides an indication of the level of inflammation in the lungs) show how well the lungs are working, helping to provide a more accurate diagnosis than listening to the chest.
But for many practices, the funding for tests is unavailable, leading GPs to make educated guesses when diagnosing lung conditions.
Seven years ago, Lucie Irwin started experiencing breathlessness that left her struggling to walk.
Her doctor gave her an asthma inhaler and when that proved ineffective "further and further treatments", the 36-year-old says.
"There was a point where I was taking three different tablets, four different inhalers, carrying them around like most people would carry their wallet and keys," she tells BBC News.
But they did not help and Ms Irwin was left "having to cancel days out with friends and family".
"I couldn't rely on my lungs to get me [through] a walk, a shopping centre or a night out," she says.
After being taken to hospital several times, Ms Irwin posted on social media and was advised by other asthma patients to request testing, which revealed she had eosinophilic asthma requiring an injectable immunosuppressant drug.
"This drug has given me my life back," she says.
"I am no longer debilitated by asthma - and this drug enables me to go out without worrying that I'm going to be blue-lighted to hospital."
Asthma and Lung UK's analysis suggests up to 750,000 people in England are misdiagnosed with asthma, costing the government an estimated £132m, every year. While a further £2.2bn is spent on avoidable hospital stays and treatment, as patients with undiagnosed asthma develop life-threatening attacks or incurable lung diseases.
Lung conditions cost the NHS £11bn every year, with COPD (chronic obstructive pulmonary disease) the second most common reason for an emergency hospital admission.
These conditions are also a leading cause of winter pressures on the NHS, as patients are more vulnerable to respiratory viruses, including flu, and colder temperatures.
Asthma and Lung UK chief executive Sarah Woolnough said: "The abysmal lack of testing, and patchy basic care, is causing avoidable harm to people with lung conditions - and the NHS."
The charity's clinical lead, Dr Andrew Whittamore, said GP practices faced "huge" barriers.
"These include lack of funding, workforce and training needed to carry out these tests properly and the physical space needed to do them," he said.
"For people with lung conditions, it means delays to their diagnosis and sometimes progression of their lung disease to more advanced stages, which can make treatment more challenging."
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