Use of PFT (spirometry) to diagnose and manage asthma in Ontario, Canada, 2000-2016

Abstract

Listen

Translate article

Background: Many national guidelines recommend conducting pulmonary function testing (PFT) for diagnosing and managing asthma. Aim: To describe and quantify PFT using spirometry trends in Ontario, Canada. Methods: A case of asthma is defined as an individual who has at least one asthma hospitalization record or two asthma physician claims over two consecutive years (Gershon AS, et al. Canadian Respiratory Journal. 2009;16(6):183–8; To T, et al. Pediatric Allergy and Immunology. 2006;17(1):69–76). All individuals living in Ontario with asthma were identified using this definition. The population-based cohort from 2000-2016 was linked across various health administrative databases to retrieve data on the use of PFT, hospitalizations, and emergency department (ED) visits. Results: PFT rates range from 44.9 in 2000 to 56 in 2016 per 100 asthma incidence for diagnosing asthma and 10.3 to 6.5 per 100 asthma prevalence for managing asthma. Over 17 years, PFT increased by 25% for diagnosing asthma and decreased by 37% for managing asthma. Asthma hospitalization rates range from 2.31 in 2000 to 0.47 in 2016 per 100 asthma prevalence while ED visit rates range from 4.33 to 1.33 per 100 asthma prevalence. Hence asthma hospitalizations and ED visits decreased by 80% and 70% over time, respectively. Conclusions: Despite guideline recommendations, PFT to diagnose and manage asthma remains low from 2000-2016 in Ontario. Although there are decreasing trends in hospitalizations and ED visits, it is important to promote the use of PFT to objectively diagnose and manage asthma in order to further reduce acute care and improve the health status of people with asthma.