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27-07-2010 | Respiratory | Article

Primary care spirometry program may identify many undiagnosed COPD patients

Abstract

Free abstract

MedWire News: Greek researchers have found that a primary care spirometry program can identify large numbers of people with previously undiagnosed chronic obstructive pulmonary disease (COPD).

Such a program may be particularly effective for identifying patients with early-stage COPD, say Markos Minas and team from the University of Thessaly Medical School.

Writing in the Primary Care Respiratory Journal, the researchers explain: "Early diagnosis of COPD is important, especially in current smokers, since smoking cessation is the only intervention which delays the rate of decline in lung function.

"Although early diagnosis of COPD does not lead directly to a delay in the rate of decline in lung function, there is evidence that smokers with COPD quit smoking more often."

The researchers studied the effectiveness of a spirometry program conducted at 15 primary care centers in Greece for identifying people with undiagnosed COPD. All patients living near the centers who were aged over 30 years without a history of upper or lower respiratory tract infection during the previous 4 weeks were invited to participate.

In total, 1526 individuals underwent spirometry.

Results revealed that 18.4% of patients who underwent lung function testing had COPD, more than half (69.0%) of whom were previously undiagnosed.

Overall, 26.0% of patient with COPD had mild (Global Initiative for Chronic Obstructive Lung Disease [GOLD] stage I) disease and 54.0% had moderate (GOLD stage II) disease.

Men, older patients, those who had smoked for more than 10 pack-years, and those with a history of respiratory infection in childhood were more likely to be diagnosed with COPD than were other individuals.

Newly diagnosed COPD patients tended to be younger and had fewer symptoms than COPD patients who had already been diagnosed with the condition.

Minas and team conclude: "Our data suggest that an invitation strategy for patients to undergo spirometry in primary care offices may identify a large proportion of patients with undiagnosed COPD, therefore contributing to the early diagnosis of COPD.

"The fact that the majority of diagnosed patients had mild-to-moderate COPD, and that newly diagnosed COPD patients in this program were younger and less symptomatic than COPD patients who were already diagnosed, further supports the need for spirometry programs in primary care for the early detection of COPD."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Mark Cowen

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