Abstract
Underdiagnosis of COPD seems to be a relevant clinical and social problem. We hypothesized that active public spirometry campaign may help identify subjects with airflow limitation consistent with COPD. The aim of the study was (1) to evaluate the willingness of random smokers to undergo public spirometry, (2) to assess the ability to obtain an acceptable quality spirometry during a public campaign, and (3) to assess the relationships between the presence and severity of respiratory symptoms and readiness to undergo spirometry. Pedestrians aged > 40 years and a smoking history >10 pack-years were recruited by medical students to fill a questionnaire and perform spirometry. Those with obstructive or borderline ventilatory insuffciency were invited and encouraged to undergo stationary spirometry in a pulmonary outpatient department. Nine hundred and five subjects meeting the inclusion criteria were invited to the study. Only 178 subjects agreed to complete the questionnaire and undergo spirometry. Airway obstruction and borderline spirometry result (classified as possible airway obstruction) were found in 22 and 37 subjects, respectively. Of these, only 15 patients attended follow-up visit to verify public spirometry results. Extrapolation of the limited data showed the incidence of newly diagnosed airway obstruction as 10.7%. Public spirometry campaign does not seem to be an effective way of COPD screening. Smokers are reluctant to undergo complimentary spirometry even in the presence of pronounced respiratory symptoms. Our observations may be helpful in elaborating future screening programs for COPD.
Highlights
Underdiagnosis of Chronic obstructive pulmonary disease (COPD) seems to be a relevant clinical and social problem
Albeit early detection and proper intervention for COPD could potentially slow the progression of the disease and minimize its negative consequences [9], spirometry is probably still performed too rarely to significantly increase the proportion of patients diagnosed with early COPD stages
In 178 subjects who entered the screening program realized by medical students trained to perform and interpret spirometry, airway obstruction and possible airway obstruction were found in 33% of the respondents
Summary
We hypothesized that active public spirometry campaign may help identify subjects with airflow limitation consistent with COPD. Material and methods: Pedestrians aged > 40 years and a smoking history > 10 pack-years were recruited by medical students to fill a questionnaire and perform spirometry. Those with obstructive or borderline ventilatory insuffciency were invited and encouraged to undergo stationary spirometry in a pulmonary outpatient department. Bednarek et al [5] showed that in primary care setting only less than 20% of patients with COPD had been diagnosed Most of these patients had severe and very severe airflow limitation. It might be estimated that about 80% of COPD patients in Poland suffered
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