Use of spirometry and patterns of prescribing in COPD in primary care

Miravitlles, Marc; Roza, Cristian de la; Naberán, Karlos; Lamban, Maite; Gobartt, Elena; Martín, Antonio

doi:10.1016/j.rmed.2007.02.019

Cited by 72 publications

(65 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The underdiagnosis of COPD remains a problem in several countries, and several studies have highlighted the importance of spirometry for the identification of obstructive lung disease in primary care. 27 The current evidence that spirometry is underused by primary care physicians, 16,28 combined with the fact that the development of screening questionnaires is not yet satisfactory, 29 has led to the suggestion that the problem of COPD underdiagnosis in primary care may be addressed by the provision of good quality spirometry in the primary care setting, [30][31][32] -as is the case in our study. The implementation of current recommendations on spirometry standards in primary care may also lead to an improvement in the diagnosis of COPD.…”

Section: Discussionmentioning

confidence: 64%

COPD prevalence and the differences between newly and previously diagnosed COPD patients in a spirometry program

Minas

Chrisi

Karetsi

et al. 2010

Primary Care Respiratory Journal

View full text Add to dashboard Cite

Aims: To evaluate the prevalence and severity of COPD in a primary care population participating in a spirometry program. Differences between newly and previously diagnosed COPD patients were identified.Methods: A spirometry program was conducted in 15 primary care centres. Visitors aged over 30 years who were willing to perform spirometry were included in this program.Results: A total of 1,526 subjects provided acceptable spirometries. COPD prevalence in our population was 18.4%, of whom 69.0% were newly diagnosed. Most patients were classified as GOLD stages I and II (26.0% and 54.0%, respectively). COPD diagnosis was related to gender (men), age (older subjects), history of repeated respiratory infection in childhood, smoking (>10 pack-years) and presence of symptoms (cough, dyspnoea, wheezing). Variables related to newly diagnosed COPD were younger age and absence of chronic cough. Conclusions:A primary care spirometry program may identify a large proportion of undiagnosed COPD patients especially in the early stages of the disease. Newly diagnosed COPD patients were of younger age and presented with less symptoms. These results support the need for spirometry programs in primary care for early COPD detection.

show abstract

Section: Discussionmentioning

confidence: 64%

COPD prevalence and the differences between newly and previously diagnosed COPD patients in a spirometry program

Minas

Chrisi

Karetsi

et al. 2010

Primary Care Respiratory Journal

View full text Add to dashboard Cite

show abstract

“…8 To our knowledge, there are no large randomised studies on the effect of pharmacological treatment of asymptomatic COPD patients detected by screening programmes, 1 while the use of spirometry as a motivating tool in smoking cessation programmes only slightly improved success rates. 20 It is therefore proposed that spirometry in the primary care setting has a central role in the diagnosis of symptomatic patients (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…7 In a primary care study more than 50% of COPD patients (stages III-IV) were receiving incorrect treatment. 8 There has been increasing interest during the last decade in the early diagnosis of COPD in the primary care setting as general practitioners (GPs) rather than pulmonary specialists make the initial diagnose and treat patients with respiratory symptoms. 9,10 The widespread application of spirometry by GPs 11,12 as well as by visiting trained nurses 13 may enhance the early diagnosis of COPD.…”

Section: Introductionmentioning

confidence: 99%

A combination of the IPAG questionnaire and PiKo-6® flow meter is a valuable screening tool for COPD in the primary care setting

Sichletidis

Spyratos

Papaioannou

et al. 2011

Primary Care Respiratory Journal

131

View full text Add to dashboard Cite

Aims: To investigate the validity of the International Primary Care Airways Guidelines (IPAG) questionnaire and PiKo-6 ® (Ferraris Respiratory Europe Ltd.) flow meter as screening tools for diagnosing chronic obstructive pulmonary disease (COPD) in the primary care setting. Methods:The first 50 patients in 25 general practice offices completed the IPAG questionnaire and underwent spirometry with the handheld PiKo-6 ® flow meter. The results were compared with official spirometry parameters after bronchodilation. All participants had no previous medical diagnosis of respiratory diseases.Results: Data from 1,078 out of 1,250 subjects (462 males, mean age 65.3±11.4 years) were analysed. The percentage of smokers was 48.4% (38±29 pack-years). COPD was diagnosed in 111 (10.3%) patients. In the subgroup of smokers the sensitivity and specificity for COPD diagnosis were 91% and 49%, respectively, for the IPAG questionnaire; 80% and 95% respectively for the PiKo-6 ® spirometer; and 72% and 97% for their combination. The negative predictive value of the questionnaire was 97%, whereas the positive predictive value of the questionnaire/ PiKo-6 ® combination was 82%. Using a cut-off score of 19 points for the IPAG questionnaire, we calculated the best combination of sensitivity (75%) and specificity (72%). Conclusions:The IPAG questionnaire and the hand-held PiKo-6 ® spirometer can be used in combination to increase the possibility of an early and accurate diagnosis of COPD in the primary care setting.

show abstract

“…In the primary care setting, access to spirometry is often limited by time constraints and difficulty in interpretation, leading to underuse. [8][9][10] Symptom-based questionnaires could be used to help differentiate between COPD and asthma among individuals thought to have obstructive lung disease. Used in conjunction with spirometry, these tools may enhance the diagnostic accuracy of obstructive lung disease.…”

Section: Introductionmentioning

confidence: 99%

Difficulties in differential diagnosis of COPD and asthma in primary care

Miravitlles

Andreu²,

Romero³

et al. 2012

Br J Gen Pract

Self Cite

View full text Add to dashboard Cite

Use of spirometry and patterns of prescribing in COPD in primary care

Abstract: Only 58.4% of the cases included had undergone spirometry. Important deficiencies were observed in the interpretation of the results of spirometry. These difficulties may influence the low implementation of treatment guidelines in COPD in PC.

Cited by 72 publications

References 37 publications

COPD prevalence and the differences between newly and previously diagnosed COPD patients in a spirometry program

COPD prevalence and the differences between newly and previously diagnosed COPD patients in a spirometry program

A combination of the IPAG questionnaire and PiKo-6® flow meter is a valuable screening tool for COPD in the primary care setting

Difficulties in differential diagnosis of COPD and asthma in primary care

Contact Info

Product

Resources

About