Contribution of spirometry to early diagnosis of chronic obstructive pulmonary disease in primary health care centers

Aysel ERDOĞAN, Elif YILMAZEL UÇAR, Ömer ARAZ, Leyla SAĞLAM, Nihal Arzu MİRİCİ
452 92

Abstract


Chronic obstructive pulmonary disease (COPD) is a common disease with increasing prevalence and mortality. We aimed to determine COPD prevalence in primary health care centers. Materials and methods: Pulmonary function tests (PFTs) and face-to-face interviews were administered to 500 patients older than 40 years of age and attending a primary health care center with any symptoms. An early reversibility test was performed on patients with a forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) ratio below 70%. The survey results, PFTs, and early reversibility test results were evaluated according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. All parameters were compared for groups with and without COPD. Results: COPD was diagnosed in 25 (5%) of the patients. Of these patients, 60% were female and 40% were male. According to GOLD guidelines, 48% of the patients had mild COPD, 36% of them had moderate COPD, and 16% of them had severe COPD. According to their history and physical examination, 72 (14.4%) participants had been previously suspected of having COPD. PFTs revealed that 59 of them did not have COPD. Conclusion: The utilization of spirometers in primary health care centers is important both for early diagnosis and to prevent misdiagnosis of COPD.

Keywords


Key words: COPD, prevalence, spirometry, early diagnosis, primary care

Full Text:

PDF

References


Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease (Updated 2010). Global Initiative for Chronic Obstructive Lung Disease, Inc.; 20 Available at http://www.goldcopd.org/uploads/users/ files/GOLDReport_April112011.pdf.

Celi BR, MacNee W. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 2004; 23: 932–46.

Mirici A, Cure O, Yilmazel Ucar E, Akgun M. Can the functionmorphology association be a model for early detection of COPD in asymptomatic smokers? Eurasian J Med 2008; 40: 127–32.

Meral M, Araz Ö, Yılmazel Uçar E, Yılmaz N, Mirici NA. Nutritional assessment via anthropometric and biochemical measurements with stable COPD. Turk J Med Sci 2012; 42: 1490–3.

Genç A, Üçok K, Günay E, Gönül Y, Karabacak H, Şener Ü, Nural S, Ünlü M. Effects of long-acting beta-2 agonist treatment on daily energy balance and body composition in patients with chronic obstructive pulmonary disease. Turk J Med Sci 2012; 42: 1414–22.

Ruthschmann OT, Janssens JP, Vermeulen B, Sarasin FP. Knowledge of guidelines for the management of COPD: a survey of primary care physicians. Respir Med 2004; 98: 932–7.

Van den Boom G, Rutten-van Molken MP, Tirimanna PR, van Schayck CP, Folgering H, van Weel C. Association between health-related quality of life and consultation for respiratory symptoms: results from the DIMCA programme. Eur Respir J 1998; 11: 67–72.

Mannino DM, Homa DM, Akinbami LJ, Ford ES, Redd SC. Chronic obstructive pulmonary disease surveillance--United States, 1971-2000. MMWR Surveill Summ 2002; 51: 1–16

Vandevoorde J, Verbanck S, Gijssels L, Schuermans D, Devroey D, De Backer J, Kartounian J, Vincken W. Early detection of COPD: a case finding study in general practice. Respir Med 2007; 101: 525–30.

Tinkelman DG, Price DB, Nordyke RJ, Halbert RJ. COPD screening efforts in primary care: what is the yield? Prim Care Respir J 2007; 16: 41–8.

Bednarek M, Maciejewski J, Wozniak M, Kuca P, Zielinski J. Prevalence, severity and underdiagnosis of COPD in the primary care setting. Thorax 2008; 63: 387–8.

Van Weel C. Underdiagnosis of asthma and COPD: is the general practitioner to blame? Monaldi Arch 2002; 57: 65–8.

Risser NL, Belcher DV. Adding spirometry, carbon monoxide and pulmonary symptom results to smoking cessation counseling: a randomized trial. J Gen Intern Med 1990; 5: 16–

Bednarek M, Gorecka D, Wielgomas J, CzajkowskaMalinowska M, Regula J, Mieszko-Filipczyk G, Jasionowicz M, Bijata-Bronisz R, Lempicka-Jastrzebska M, Czajkowski M et al. Smokers with airway obstruction are more likely to quit smoking. Thorax 2006; 61: 869–73.

Halbert RJ, Isonaka S, George D, Iqbal A. Interpreting COPD prevalence estimates: what is the true burden of disease? Chest 2003; 123: 1684–92.

Burney PG, Luczynska C, Chinn S, Jarvis D. The European Community Respiratory Health Survey. Eur Respir J 1994; 7: 954–60. de Marco R, Accordini S, Cerveri I, Corsico A, Sunyer J, Neukirch F, Künzli N, Leynaert B, Janson C, Gislason T et al. An international survey of chronic obstructive pulmonary disease in young adults according to GOLD stages. Thorax 2004; 59: 120–5.

Yıldırım N. From smoking to COPD and Lung cancer. In: Umut S, Yıldırım N, editors. Chronic Obstructive Lung Disease. İstanbul: University of İstanbul Cerrahpaşa Medical Faculty Chest Department Books; 2005. p.323–9.

Samurkaşoğlu B. Epidemiology and risk factors. In: Saryal S, Acıcan T, editors. Chronic obstructive lung disease in current knowledge light. Ankara: Bilimsel Tıp Yayınevi; 2003. p.9–20.

Kocabas A, Hancioglu A, Turkyilmaz S, Unalan T, Umut S, Cakir B, Vollmer W, Buist S. Prevalence of COPD in Adana, Turkey (BOLD-Turkey Study). American Thoracic Society International Conference; 2006. p.A543.