Analyses of the rate of spirometry examination and its related factors in chronic obstructive pulmonary diseasepatients aged 40 years or older in China, 2014-2015

Abstract

Objective: To understand the rate of spirometry examination and its related factors among chronic obstructive pulmonary disease (COPD) patients aged ≥40 years in China from 2014 to 2015, and provide evidence for diagnosis, treatment and management of COPD patients normatively. Methods: Data were obtained from 2014-2015 COPD surveillance, China. The previous lung function examination status and other information of the subjects were collected by face-to-face survey. We defined COPD as a post-bronchodilator FEV(1): FVC less than 70%. A total of 9 130 COPD patients were included in the analysis of this study. The rate of spirometry examination and its 95% confidence interval (CI) were estimated in COPD patients aged ≥40 years with complicated sampling weights. Meanwhile, the spirometry examination related factors were analyzed. Results: The estimated rate of spirometry examination among COPD patients was 5.9% (95%CI: 4.9%-6.9%), 6.1% (95%CI: 5.2%-7.1%) for men and 5.3% (95%CI: 4.0%-6.6%) for women. The rate was significantly higher in urban population than in rural (P<0.001). With the increase of education level, the rate of spirometry examination among COPD patients increased gradually (P<0.001). The rate of spirometry examination was 4.0% (95%CI: 3.1%-4.9%) among COPD patients in agricultural industry. The rate of spirometry examination among COPD patients with awareness of pulmonary function test was 32.3% (95%CI: 26.4%-38.1%). The rate of spirometry examination among COPD patients with previous chronic respiratory disease and respiratory symptoms were 13.7%(95%CI:11.5%-15.9%), 8.8%(95%CI:7.2%-10.4%), respectively. The rate of spirometry examination among COPD patients exposed to occupational dust and/or harmful gases was 5.7% (95%CI: 4.6%-6.9%). The rate of spirometry examination in former smokers among COPD patients was 10.2% (95%CI: 8.0%-12.4%), higher than those in current smokers (4.2%, 95%CI: 3.3%-5.1%) and non-smokers (6.3%, 95%CI: 5.1%-7.6%). Conclusion: The rate of spirometry examination is extremely low among COPD patients aged ≥40 in China, and the standardized diagnosis, treatment and management of COPD patients need to be improved urgently.