scholarly journals Early detection of asthma and chronic obstructive pulmonary disease in primary care patients

2013 ◽  
Vol 66 (1-2) ◽  
pp. 46-52 ◽  
Author(s):  
Marija Vukoja ◽  
Predrag Rebic ◽  
Zorica Lazic ◽  
Marija Mitic-Milikic ◽  
Branislava Milenkovic ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Primary Care ◽  
Pulmonary Disease ◽  
General Practitioners ◽  
Primary Care Physicians ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Number Of Patients ◽  
Primary Care Patients

Introduction. Asthma and chronic obstructive pulmonary disease are often unrecognized and undertreated. The aim of this study was to describe the frequency of chronic obstructive pulmonary disease and asthma in primary care patients in Serbia, and to examine the agreement between general practitioners and pulmonologists on the diagnosis of chronic obstructive pulmonary disease and asthma. Material and Methods. In this multicenter observational study, the general practitioners identified eligible patients from October 2009 to June 2010. The study included all adult patients with respiratory symptoms and/or smoking history based on structured interview. The patients were referred to a pulmonologist and underwent a diagnostic work-up, including spirometry. Results. There were 2074 patients, 38.4% men, their mean age being 54?15.5 years. The patients were mostly current (40.3%) or ex-smokers (27.4%). The common symptoms included shortness of breath (84.9%), cough (79.1%) and wheezing (64.3%). The diagnosis of chronic obstructive pulmonary disease was confirmed by pulmonologists in 454 (21.9%) and asthma in 455 (21.9%) patients. The chronic obstructive pulmonary disease was newly diagnosed in 226 (10.9%) and asthma in 269 (13%) of the cases. There was a moderate agreement between the pulmonologists and general practitioners on the diagnosis of chronic obstructive pulmonary disease (kappa 0.41, 95%CI 0.36-0.46) and asthma (kappa 0.42, 95% CI 0.37-0.465). Conclusion. A significant number of patients seen in the general practitioner?s office were diagnosed with chronic obstructive pulmonary disease or asthma and half of them represent new cases. A substantial proportion of patients referred to a pulmonologist by primary care physicians have been misdiagnosed.

scholarly journals Exclusion Spirometry: A Good Idea

2004 ◽  
Vol 11 (3) ◽  
pp. 185-186
Author(s):  
Nick R. Anthonise
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Primary Care ◽  
Pulmonary Disease ◽  
Forced Vital Capacity ◽  
Primary Care Physicians ◽  
Lung Diseases ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

In this issue of theCanadian Respiratory Journal, Almirall and Bégin (pages 195 to 196) make a suggestion aimed at increasing the use of spirometry by primary care physicians, as well as family and general practitioners. The idea is that spirometry should be performed not necessarily to make specific diagnoses, but to rule in or out the possibility of a number of lung diseases, most notably, chronic obstructive pulmonary disease (COPD). If the patient demonstrates normal forced vital capacity and forced expiratory volume in 1 s, then he or she does not have COPD; if the results are not normal, then COPD is a possibility that can be further investigated.

scholarly journals The feasibility of an innovative GP-physiotherapist partnership to identify and manage chronic obstructive pulmonary disease (INTEGRATED): study protocol

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Lisa Pagano ◽  
Zoe McKeough ◽  
Sally Wootton ◽  
Stephen Crone ◽  
Deborah Pallavicini ◽  
...  
Keyword(s):  
Physical Activity ◽  
Chronic Obstructive Pulmonary Disease ◽  
Primary Care ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Model Of Care ◽  
Obstructive Pulmonary Disease ◽  
Diagnosis And Management ◽  
Number Of Patients ◽  
A Current

Abstract Background Chronic obstructive pulmonary disease (COPD) contributes significantly to mortality, hospitalisations and health care costs worldwide. There is evidence that the detection, accurate diagnosis and management of COPD are currently suboptimal in primary care. Physiotherapists are well-trained in cardiorespiratory management and chronic care but are currently underutilised in primary care. A cardiorespiratory physiotherapist working in partnership with general practitioners (GPs) has the potential to improve quality of care for people with COPD. Methods A prospective pilot study will test the feasibility of an integrated model of care between GPs and physiotherapists to improve the diagnosis and management of people with COPD in primary care. Four general practices will be selected to work in partnership with four physiotherapists from their local health district. Patients at risk of developing COPD or those with a current diagnosis of COPD will be invited to attend a baseline assessment with the physiotherapist, including pre- and post-bronchodilator spirometry to identify new cases of COPD or confirm a current diagnosis and stage of COPD. The intervention for those with COPD will involve the physiotherapist and GP working in partnership to develop and implement a care plan involving the following tailored to patient need: referral to pulmonary rehabilitation (PR), physical activity counselling, medication review, smoking cessation, review of inhaler technique and education. Process outcomes will include the number of people invited and reviewed at the practice, the proportion with a new diagnosis of COPD, the number of patients eligible and referred to PR and the number who attended PR. Patient outcomes will include changes in symptoms, physical activity levels, smoking status and self-reported exacerbations. Discussion If feasible, we will test the integration of physiotherapists within the primary care setting in a cluster randomised controlled trial. If the model improves health outcomes for the growing numbers of people with COPD, then it may provide a GP-physiotherapist model of care that could be tested for other chronic conditions. Trial registration ANZCTR, ACTRN12619001127190. Registered on 12 August 2019—retrospectively registered.

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