Abstract
Aim: To describe the accuracy of diagnosis of COPD from practice nurse
(PN) case-finding appointments.
Methods: PNs undertook 8+ hours of workshop training in spirometry and
case-finding for diagnosis of COPD. Practices invited patients identified as
being at risk of COPD (age 40–85, history of smoking, no documented diag-
nosis of COPD) to attend a case-finding visit. Quality control of spirometry
traces was provided by an expert. For patients identified by PNs as having
COPD, spirometry was also performed during home visits by experienced
project officers.
Results: 36 practices participated; 10 231 invitation letters were sent, 1642
patients (16%) attended a case-finding visit, and 287 (17.5%) were given a
diagnosis of COPD by the PN. Of these, 254 (60% male, average age 66
years) were available for project officer visits; 31% were current smokers. The
diagnosis of COPD (post-bronchodilator (BD) FEV 1/FVC <0.7), was confirmed
in 69% cases. Of these, COPD severity, based on COPD-X criteria, was mild
in 45%, moderate in 22% and severe in 2% (borderline in 31%). Patients for
whom the diagnosis of COPD was not confirmed were younger (62 vs 68
years, p < 0.0001), and had higher post-BD FEV 1 (83% vs 71% predicted, p
< 0.0001) and lower BD reversibility (5.3% vs 9.1%, p = 0.005); they were
more likely to have a restrictive pattern than if the diagnosis of COPD was
confirmed (40% vs 21%, p = 0.002).
Conclusions: Screening in primary care can identify patients with undiag-
nosed COPD, but despite training and support, PNs had difficulty interpreting
spirometry.
Original language | English |
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Article number | O109 |
Pages (from-to) | 37-37 |
Number of pages | 1 |
Journal | Respirology |
Volume | 18 |
Issue number | Supplement 2 |
DOIs | |
Publication status | Published - Apr 2013 |
Externally published | Yes |