Early detection of COPD in general practice

Int J Chron Obstruct Pulmon Dis. 2011;6:123-7. doi: 10.2147/COPD.S16929. Epub 2011 Jan 27.

Abstract

Background and aim: Early detection enables the possibility for interventions to reduce the future burden of COPD. The Danish National Board of Health recommends that individuals >35 years with tobacco/occupational exposure, and at least 1 respiratory symptom should be offered a spirometry to facilitate early detection of COPD. The aim, therefore, was to provide evidence for the feasibility and impact of doing spirometry in this target population.

Methods: Participating general practitioners (GPs) (n = 335; 10% of the Danish GPs) recruited consecutively, subjects with >35 years exposure, no previous diagnosis of obstructive lung disease, and at least 1 of the following symptoms: cough, dyspnea, wheezing, sputum, or recurrent respiratory infection. Data on age, smoking status, pack-years, body mass index (BMI), dyspnea score (Medical Research Council, MRC), and pre-bronchodilator spirometry (FEV(1), FEV(1)% predicted, FEV(1)/FVC) were obtained.

Results: A total of 3.095 (51% females) subjects was included: mean age 58 years, BMI 26.3, and 31.5 pack-years. The majority of subjects (88%) reported MRC score 1 or 2. FEV(1)/FVC-ratio ≤ 0.7 was found in 34.8% of the subjects; the prevalence of airway obstruction increased with age and decreased with increasing BMI, and was higher in men and current smokers. According to the level of FEV(1), 79% of the subjects with airway obstruction had mild to moderate COPD.

Conclusions: More than one-third of the recruited subjects had airway obstruction (FEV(1)/ FVC < 0.7). Early detection of COPD appears to be feasible through offering spirometry to adults with tobacco/occupational exposure and at least 1 respiratory symptom.

Keywords: COPD; airway obstruction; general practice; screening; spirometry.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Denmark / epidemiology
  • Early Diagnosis
  • Feasibility Studies
  • Female
  • Forced Expiratory Volume
  • General Practice*
  • Humans
  • Lung / physiopathology*
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Predictive Value of Tests
  • Prevalence
  • Pulmonary Disease, Chronic Obstructive / diagnosis*
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Smoking / epidemiology
  • Spirometry*
  • Vital Capacity