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COPD screening efforts in primary care: what is the yield?
David G Tinkelman1, David Price, Robert J Nordyke
1Health Initiatives, National Jewish Medical and Research Center, Denver, USA.
Summary
Screening smokers over 40 identified a high prevalence of undiagnosed chronic obstructive pulmonary disease (COPD), with many cases being moderate to severe. Early diagnosis is crucial for timely intervention and improved quality of life.
Area of Science:
- Pulmonology
- General Practice
- Epidemiology
Background:
- Underdiagnosis of chronic obstructive pulmonary disease (COPD) is a significant issue, yet its extent is seldom quantified.
- A study was conducted to measure the prevalence of undiagnosed COPD in high-risk, ambulatory patients.
Purpose of the Study:
- To determine the prevalence of undiagnosed COPD in smokers aged 40 and above within primary care settings.
- To assess the severity of newly diagnosed COPD cases.
Main Methods:
- Smokers aged 40+ from general practices in Scotland and the US, without prior COPD diagnosis or medication, were recruited.
- Participants underwent pre- and post-bronchodilator spirometry, with COPD defined as a post-bronchodilator FEV1/FVC ratio below 0.70.
Main Results:
- Spirometry was completed by 818 patients, revealing that 155 (18.9%) met the study criteria for COPD.
- Of the diagnosed COPD cases, 57.4% were mild, 36.8% moderate, and 5.8% severe, according to GOLD criteria. No patients had very severe COPD.
Conclusions:
- General practice screening of individuals over 40 who smoke can uncover 10-20% with undiagnosed COPD.
- A significant portion of these cases present with moderate to severe disease, highlighting the need for early, targeted case-finding and smoking cessation interventions.
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