COPD underdiagnosed in Canada
MedWire News: Many people with chronic obstructive pulmonary disease (COPD) are unaware that they have the condition, Canadian study results suggest.
“These findings suggest that adults who attend a primary care practice with known risk factors for COPD are important targets for screening and early intervention,” say Roger Goldstein (University of Toronto, Ontario) and colleagues.
Goldstein and team identified 1459 patients from three primary care centers who were at high risk for COPD due to a smoking history of at least 20 pack-years and being older than 40 years. Of these, 1003 underwent lung functions tests (spirometry) and completed questionnaires on respiratory symptoms.
The researchers found that 208 (20.7%) participants had COPD, defined as FEV1/forced vital capacity ratio of less than 0.7 and an FEV1 of less than 80% of the predicted value.
However, just 67 (32.7%) participants who met the criteria for COPD reported being diagnosed with the condition before enrolment in the study.
There were no significant differences between diagnosed and undiagnosed COPD patients in terms of age, gender, current smoking status, and number of visits to a primary care practitioner due to a respiratory problem, the researchers note in the Canadian Medical Association Journal.
Goldstein et al conclude: “Our results call for a higher index of suspicion for the presence of COPD in patients aged 40 years or older with a substantial smoking history, as well as a wider use of spirometry for diagnosis.” They add: “Further research is indicated to define more clearly the reasons for underdiagnosis and overdiagnosis of COPD in primary care settings.”
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By Mark Cowen