The prevalence of bronchial asthma has been rising annually, yet primary healthcare institutions still face difficulties in early diagnosis and treatment. Bronchial provocation test (BPT) is an important diagnostic tool with significant value. Although BPT is widely used both domestically and internationally, its prevalence in Guangdong Province remains low and development is uneven. Understanding the current status and issues of BPT implementation in Guangdong will help improve early diagnosis and management of bronchial asthma.

To investigate the current status of bronchial challenge tests in Guangdong Province and analyze the issues that need improvement during its development.

This study used a convenience sampling method to select 236 medical institutions from 21 cities in Guangdong Province, including 19 primary hospitals, 69 secondary hospitals, and 148 tertiary hospitals. Each institution appointed one staff member from the respiratory department or pulmonary function laboratory to complete a questionnaire. The questionnaire covered hospital information, years of experience in performing bronchial challenge tests, equipment used, challenge agents, adverse event management, staff training, quality control measures, and knowledge of bronchial challenge test protocols.

The study revealed that only 57.63% of the 236 medical institutions surveyed had implemented bronchial challenge tests, with most being tertiary hospitals and some secondary hospitals, while primary hospitals had very low rates of implementation. Of the institutions conducting the tests, 77.94% used quantitative nebulization, and 97.79% used imported equipment, though the use of domestic brands had increased significantly (13.97%). In terms of quality control, only 66.18% of institutions performed regular calibration of nebulization devices, indicating a lack of standardized quality control measures. There were also discrepancies in healthcare workers' understanding of bronchial challenge test-related knowledge, particularly in the recognition of positive indicators and standards for positive results.

The prevalence of bronchial challenge tests in Guangdong Province remains low, and the implementation is uneven, with primary hospitals not conducting these tests at all. There is a lack of standardization in calibration, methods, quality control, and interpretation of results. Pulmonary function staff urgently need standardized training to improve these areas.