Active case finding strategy for chronic obstructive pulmonary disease with handheld spirometry

Kim, Joo Kyung; Lee, Chang Min; Park, Ji Young; Kim, Joo Hee; Park, Sunghoon; Jang, Seung Hun; Jung, Ji Ye; Yoo, Kwang Ha; Park, Yong Bum; Rhee, Chin Kook; Kim, Deog Kyeom; Hwang, Yong Il

doi:10.1097/md.0000000000005683

Cited by 21 publications

(28 citation statements)

References 26 publications

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“…While screening for COPD in asymptomatic adults is not recommended,7 active case-finding strategies should be considered for early diagnosis of COPD in high-risk subjects 8–11. Although smoking is the most commonly encountered risk factor for COPD,1 COPD awareness among smokers is low in Korea.…”

Section: Introductionmentioning

confidence: 99%

<p>Male current smokers have low awareness and optimistic bias about COPD: field survey results about COPD in Korea</p>

Hwang

Park

Yoon

et al. 2019

COPD

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BackgroundSmoking is a major risk factor for COPD. However, there is low COPD awareness among smokers. We conducted a field survey to investigate COPD awareness, optimistic bias associated with COPD, and COPD prevalence (using handheld spirometry) among current male smokers.Subjects and methodsWe enrolled currently smoking males aged over 40 years, who completed a self-administered questionnaire. The questionnaire consisted of six parts: 1) baseline demographics, 2) participants’ awareness of COPD and pulmonary function tests, 3) presence of COPD-related respiratory symptoms and experience with pulmonary function testing, 4) optimistic bias about COPD, 5) willingness to change attitude toward respiratory health, and 6) preference of media for obtaining health-related information. Pulmonary function was assessed via handheld spirometry by two experienced pulmonary function laboratory technicians after completion of the questionnaire.ResultsWe enrolled 105 participants. Only 24.8% knew of COPD. Awareness of pulmonary function testing was reported by 41.9% of participants, and 30.5% had previously undertaken pulmonary function tests. Among the subjects who had not previously undergone pulmonary function tests, 47% were not aware of their existence. The mean optimistic bias scores were 3.9 and 4.0, respectively, reflecting the general perception, among participants, that they were about as likely to develop COPD as similarly aged smokers and friends, respectively. A total of 40.0% of participants perceived personal COPD risk to be lower than COPD risk among their friends. Abnormal handheld spirometry results were observed in 28.6% of participants. Among the subjects with abnormal handheld spirometry results, 36.7% had FEV1 values <50% of the predicted value.ConclusionIn conclusion, current male smokers had poor awareness of COPD. Participants perceived their risk of developing COPD to be no higher than their friends’ COPD risk. Strategies to increase COPD awareness among high-risk groups should be developed.

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Section: Introductionmentioning

confidence: 99%

<p>Male current smokers have low awareness and optimistic bias about COPD: field survey results about COPD in Korea</p>

Hwang

Park

Yoon

et al. 2019

COPD

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“…Research ERF in patients with COPD is optional and allows to objectify the degree of airflow obstruction, reversibility and its variability, and the effectiveness of treatment and physical rehabilitation carried out (Borges, 2014;Deepak, 2014; Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease, GOLD Executive Summary, 2017; Kim, 2016).…”

Section: Resultsmentioning

confidence: 99%

Efficiency physical rehabilitation patients with chronic obstructive pulmonary disease with moderate severity

Grygus

Maistruk

Żukow

2019

Journal of Human Sport and Exercise - 2019 - Spring Conferences of Sports Science

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The aim-to examine the effectiveness of the impact of the proposed technology for physical rehabilitation of respiratory function in patients with chronic obstructive pulmonary disease of moderate severity. The study involved 162 patients. Analysing the average values of respiratory function of patients in both groups at baseline, it was determined that they are much lower than normal and did not differ among themselves, which indicates poor functional capacity of the lungs and bronchial patency. For each patient selected individual program of physical rehabilitation, taking into account the physical features of lung function parameters, specific physiological and psychopathological disorders. Patients of the main group before observed positive dynamics: reducing breathlessness, improved discharge sputum. The use of physical rehabilitation led to the extension of functionality of patients expressed increasing average values of indicators of lung function studied in the main group at the end of studies that demonstrate its effectiveness.

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“… 15 , 18 Moreover, a recent publication showed that the added value of a screening questionnaire next to microspirometry is low. 14 …”

Section: Discussionmentioning

confidence: 99%

Point of care microspirometry to facilitate the COPD diagnostic process in primary care: a clustered randomised trial

Schermer

Vatsolaki

Behr³

et al. 2018

npj Prim Care Resp Med

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We studied if pre-bronchodilator FEV1/FEV6 determinations with microspirometers by GPs improve the diagnostic process for COPD in a 6–8 month clustered randomised controlled trial in Dutch general practices (http://www.trialregister.nl: NTR4041). GPs allocated to microspirometry (MI) used COPD-6® microspirometers in patients ≥50 years old with a smoking history and respiratory complaints that could indicate undiagnosed COPD and ask to refer patients for full spirometry if MI was positive (FEV1/FEV6 <0.73). Introduction of the COPD-6® was postponed in the usual care (UC) group. GPs of both study arms were asked to list all patients that fulfilled study criteria and at the end of the study we screened the electronic medical record system for number of patients that fulfilled study criteria and visited their GP within the study period. Main end point was a documented diagnostic conclusion of COPD within 3 months after the patient’s visit. We used multilevel logistic regression with correction for relevant covariates. Next, we described the process of care. 21 practices (88 GPs) participated and 416 possible undiagnosed COPD patient visited these practices in the study period. 78 (of 192 visiting) subjects were listed by MI GPs and diagnostic conclusions were documented in 77%, compared to 61 listed (of 224 visiting) subjects and 44% with documented diagnostic conclusions by UC GPs (Odds Ratio: OR: 4.3, 95%CI: 1.6–11.5). Microspirometry improved the diagnostic process for possible underlying COPD in patients who consulted their GP with respiratory symptoms, but the majority of possible undiagnosed COPD patients remained unrecognised by GPs.

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Active case finding strategy for chronic obstructive pulmonary disease with handheld spirometry

Abstract: Supplemental Digital Content is available in the text

Cited by 21 publications

References 26 publications

<p>Male current smokers have low awareness and optimistic bias about COPD: field survey results about COPD in Korea</p>

<p>Male current smokers have low awareness and optimistic bias about COPD: field survey results about COPD in Korea</p>

Efficiency physical rehabilitation patients with chronic obstructive pulmonary disease with moderate severity

Point of care microspirometry to facilitate the COPD diagnostic process in primary care: a clustered randomised trial

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