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Early detection of COPD in general practice

2011; Dove Medical Press; Linguagem: Inglês

10.2147/copd.s16929

1178-2005

Charlotte Suppli Ulrik, Charlotte Suppli Ulrik,

Asthma and respiratory diseases

Background and aim : Early detection enables the possibility for interventions to reduce the future burden of COPD. The Danish National Board of Health recommends that individuals >35 years with tobacco/occupational exposure, and at least 1 respiratory symptom should be offered a spirometry to facilitate early detection of COPD. The aim, therefore, was to provide evidence for the feasibility and impact of doing spirometry in this target population. Methods: Participating general practitioners (GPs) (n = 335; 10% of the Danish GPs) recruited consecutively, subjects with >35 years exposure, no previous diagnosis of obstructive lung disease, and at least 1 of the following symptoms: cough, dyspnea, wheezing, sputum, or recurrent respiratory infection. Data on age, smoking status, pack-years, body mass index (BMI), dyspnea score (Medical Research Council, MRC), and pre-bronchodilator spirometry (FEV 1 , FEV 1 % predicted, FEV 1 /FVC) were obtained. Results: A total of 3.095 (51% females) subjects was included: mean age 58 years, BMI 26.3, and 31.5 pack-years. The majority of subjects (88%) reported MRC score 1 or 2. FEV 1 /FVC-ratio ≤ 0.7 was found in 34.8% of the subjects; the prevalence of airway obstruction increased with age and decreased with increasing BMI, and was higher in men and current smokers. According to the level of FEV 1 , 79% of the subjects with airway obstruction had mild to moderate COPD. Conclusions: More than one-third of the recruited subjects had airway obstruction (FEV 1 / FVC < 0.7). Early detection of COPD appears to be feasible through offering spirometry to adults with tobacco/occupational exposure and at least 1 respiratory symptom. Keywords: COPD, spirometry, general practice, airway obstruction, screening