Background Chronic obstructive pulmonary disease (COPD) is a leading cause
of disability, hospital admission and premature mortality, but is often
undiagnosed. This study assessed the effectiveness, feasibility and
acceptability of COPD case finding by practice nurses performing
spirometry on patients identified as being at risk of developing COPD.
Discussion This study confirmed that COPD is underdiagnosed, with 20% of those
at risk and attending for screening having COPD. The search strategy
successfully identified patients at risk. Further training in spirometry
would be required for practice nurses to increase the accuracy of
the diagnoses. The opportunity cost would require consideration.
The acceptability to patients is also an issue, this may be related
to the recruitment method or the intervention. This study also does
not answer whether earlier diagnosis in these patients leads to any
change in outcomes.
Results Seventy-nine patients attended, 16 (20.3% of attendees) had COPD
diagnosed on spirometry; practice nurses correctly identified 10 of
the 16, but also incorrectly identified a further six patients as having
COPD. One patient in the usual care group was diagnosed with COPD,
but this was not confirmed on spirometry.
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