NDLI: Spirometry is underused in the diagnosis and monitoring of patients with chronic obstructive pulmonary disease (COPD)

Content Provider	PubMed Central
Author	Cho, Yu Wai Nga, Fu Sau Tai, Emily Lai-bun Yeung, Yiu Cheong Kwong, Kwok Chu Chang, Yui Tam, Cheuk Ming Yiu, Yuk Kwan
Copyright Year	2013
Abstract	Spirometry is important in the diagnosis and management of chronic obstructive pulmonary disease (COPD), yet it is a common clinical observation that it is underused though the extent is unclear. This survey aims to examine the use of spirometry in the diagnosis and management of COPD patients in a district in Hong Kong. It is a cross-sectional survey involving four clinic settings: hospital-based respiratory specialist clinic, hospital-based mixed medical specialist clinic, general outpatient clinic (primary care), and tuberculosis and chest clinic. Thirty physician-diagnosed COPD patients were randomly selected from each of the four clinic groups. All of them had a forced expiratory volume in 1 second (FEV1) to forced vital capacity ratio less than 0.70 and had been followed up at the participating clinic for at least 6 months for COPD treatment. Of 126 patients who underwent spirometry, six (4.8%) did not have COPD. Of the 120 COPD patients, there were 111 males and mean post-bronchodilator FEV1 was 46.2% predicted. Only 22 patients (18.3%) had spirometry done during diagnostic workup, and 64 patients (53.3%) had spirometry done ever. The only independent factor predicting spirometry done ever was absence of old pulmonary tuberculosis and follow-up at respiratory specialist clinic. Age, sex, smoking status, comorbidities, duration of COPD, percentage predicted FEV1, body mass index, 6-minute walking distance, and Medical Research Council dyspnea score were not predictive. We conclude that spirometry is underused in general but especially by nonrespiratory physicians and family physicians in the management of COPD patients. More effort at educating the medical community is urgently needed.
Related Links	http://dx.doi.org/10.2147/COPD.S48659
Ending Page	395
Page Count	7
Starting Page	389
File Format	PDF
ISSN	11782005
e-ISSN	11782005
Journal	International Journal of Chronic Obstructive Pulmonary Disease
Volume Number	8
Language	English
Publisher	Dove Medical Press
Publisher Date	2013-01-01
Access Restriction	Open
Rights Holder	Dove Medical Press
Subject Keyword	Research in Higher Education
Content Type	Text
Resource Type	Article
Subject	Pulmonary and Respiratory Medicine Public Health, Environmental and Occupational Health Health Policy

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