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Early Diagnosis Models for COPD

Spirometry is a diagnostic lung function test used to determine how well the lungs are working by measuring how much air, and how quickly, a person is able to breathe in and out. Spirometry is required to make a clinical diagnosis of COPD.

Early diagnosis of COPD allows opportunities to implement interventions in the early stages of the disease and can decrease the rate of decline in lung function. Beginning treatment in the early stages of the disease can produce more favorable outcomes and improve quality of life.

Examples of Early Diagnosis Models

  • The American Lung Association offers an Implementation and Interpretation of Spirometry in the Primary Care Practice training course designed for healthcare providers. Their website includes a schedule of upcoming trainings as well as videos on how to perform a spirometry test and other resources.
  • Programs have had success in increasing the use of spirometry in asthma diagnosis and care. The Asthma Toolkit Program uses a registered nurse to travel to primary care practices in rural eastern Colorado, providing spirometers and education materials to providers and patients. The program has demonstrated a tenfold increase in the use of spirometry.
  • The Mobile Spirometry Unit, developed through a partnership among the American Association for Respiratory Care, the COPD Foundation, and the National Heart, Lung, and Blood Institute, was launched in 2007. The program began with a mobile unit traveling across the U.S. to perform spirometry at community events. While the mobile unit is no longer in use, the program still travels to a variety of health-related events offering educational materials and relevant screening.

Considerations for Implementation

A 2017 COPD Foundation statement reports that COPD is often diagnosed late and may even be untreated or undertreated even when an early diagnosis is given. For many rural healthcare providers, diagnosis and treatment of COPD were not significant components of their training. Therefore, spirometry is often underused.

Family practitioners are at the forefront of detecting, diagnosing, and treating patients with COPD symptoms. In Addressing the Burden of Chronic Obstructive Pulmonary Disease (COPD) in Rural America: Policy Brief and Recommendations, stakeholders noted their concerns about the need for rural healthcare providers to be better educated about diagnosing COPD using spirometry. There has been some confusion related to the use of spirometry for general screening of COPD, for which there is no evidence base in asymptomatic adults.

Resources to Learn More

Office Spirometry in Primary Care for the Diagnosis and Management of COPD: National Lung Health Education Program Update
Document
Discusses the use and underutilization of spirometry for diagnosing COPD in primary care settings.
Author(s): Ruppel, G., Carlin, B., Hart, M., & Doherty, D.
Citation: Respiratory Care, 63 (2) 242-252
Date: 2/2018