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Barriers to the use of spirometry in general practice

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posted on 2023-05-25, 22:33 authored by Walters, JAE, Hansen, EC, Mudge, P, Johns, DP, Walters, EH, Wood-Baker, R
BACKGROUND: Guidelines advise chronic obstructive pulmonary disease (COPD) should be diagnosed and managed by using spirometry to demonstrate irreversible airflow limitation and monitor change in smokers and ex-smokers aged over 35 years. METHODS: A cross-sectional study of patients and their general practitioners investigating use of spirometry in COPD in two practices by lung function assessment, review of practice records, interviews and focus groups. RESULTS: Sixteen GPs, and 38 patients with a diagnosis of COPD participated. At diagnosis, although 72% had spirometry, this occurred in only 41% of 17 patients diagnosed by a GP; but in all 19 cases when a specialist was involved. Diagnosis often occurred late, despite all patients having previously recorded symptoms typical of COPD. General practitioners expressed a preference to diagnose COPD on clinical grounds. Although 58% of patients had recent spirometry for current management, only 32% were performed by their GP. There were organisational and technical barriers to spirometry and poor recognition of the essential role of spirometry in the diagnosis of COPD. DISCUSSION: There are a number of potentially reversible factors that hinder practice recommendations regarding the use of spirometry in general practice to diagnose and manage COPD.


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Australian Family Physician



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Copyright 2007 Australian Family Physician. Reproduced with permission from The Royal Australian College of General Practitioners. Text and images copyright of Australian Family Physician. Permission to reproduce must be sought from the publisher, The Royal Australian College of General Practitioners. This permission is for English reproduction only. Permission is not granted for future revisions, future editions or ancillaries of any works. Permission must be requested on a case by case basis.

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