Abstract
BackgroundGeneral practitioners (GPs) in Norway increasingly use spirometry diagnostically as well as in follow up of patients with respiratory complaints, but little is known about their skills and knowledge in this area. The aim of the present study was to investigate how GPs interpret a case history and spirometry recordings of a patient with chronic obstructive pulmonary disease (COPD), and their knowledge about their own spirometer.MethodsA web-based survey, consisting of a case history and spirometry recordings of a patient with COPD, was distributed to the 4700 members of the Norwegian GP Association. In addition to background information about themselves and their spirometer, topics included whether they requested, and how they interpreted, a spirometry reversibility-test, identification of the of most likely diagnosis, and recognition of the spirometry parameters used to diagnose COPD and grade airway obstruction. Immediate feedback was provided for educational purposes.ResultsSix hundred thirty GPs responded. Twenty six percent would not request a reversibility test, but 81% identified COPD as the most likely diagnosis. Less than 50% correctly identified the spirometry parameters used for diagnosis of COPD and grading the airway obstruction. One in five (21%) did not know which spirometer was used in their own practice, and 49 and 61% did not know which reference values were used for adults and children, respectively. Participants evaluated the survey as useful (average 74 points on a 0–100 scale) and would like more case-based surveys concerning use of spirometry in the future (average 91 points).ConclusionIn this cohort of self-selected GPs, probably more interested in respiratory medicine than the average GP, we identified several problem areas and gaps in knowledge regarding the use of spirometry.
Highlights
General practitioners (GPs) in Norway increasingly use spirometry diagnostically as well as in follow up of patients with respiratory complaints, but little is known about their skills and knowledge in this area
While 96% of spirometry recordings were of adequate technical quality, only 73% of spirometries from patients with a clinical diagnosis of chronic obstructive pulmonary disease (COPD) were consistent with obstruction
In 2019, we distributed a web-based multiple-choice survey (Additional file 1) to the 4712 practicing GPs registered as members of the Norwegian GP Association, with the following case history: A previously healthy man in the age group 50-59 years presents with complaints of progressive breathlessness on physical exertion over the past year
Summary
General practitioners (GPs) in Norway increasingly use spirometry diagnostically as well as in follow up of patients with respiratory complaints, but little is known about their skills and knowledge in this area. The aim of the present study was to investigate how GPs interpret a case history and spirometry recordings of a patient with chronic obstructive pulmonary disease (COPD), and their knowledge about their own spirometer. General practitioners (GPs) in Norway increasingly use spirometry diagnostically as well as a tool to evaluate lung function during follow up of patients with respiratory complaints. In a study from seven Norwegian GP offices during 2009/2010, patients with a record of asthma or chronic obstructive pulmonary disease (COPD) were invited for clinical examination and spirometry to validate their diagnoses [2]. A recent case-based survey among 250 Swedish GPs concluded that the GPs indicated they would often request a spirometry when appropriate, only 23% could adequately interpret the spirometric recordings [4]
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