COPD: Practical aspects of case finding, diagnosing and monitoring
journal contribution
posted on 2023-05-22, 02:10authored byWalters, JAE, Crockett, AJ, McDonald, VM
Key points:
Diagnosis of COPD is often delayed and a high proportion of cases in primary care are unrecognised.
COPD is often misdiagnosed in primary care, probably as a result of not using spirometry for diagnosis.
Screening systematically or opportunistically with questionnaires can be used to case-find in general practice. Expiratory flow devices are used to determine the need for diagnostic testing.
Spirometry is essential to diagnose COPD. COPD is present if the post- bronchodilator FEV1/FVC ratio is below 0.7 and FEV1 is less than 80% predicted.
Telling smokers their ‘lung age’ after spirometry increases their chances of successfully quitting.
The results of spirometry together with symptoms and exacerbation frequency guides the management of COPD.
Complex lung function tests to distinguish between asthma and COPD are not usually required.