[Utilization of diagnostic tools and health care services for obstructive lung disease]

Chronic obstructive pulmonary disease (COPD) has been under-diagnosed and the patients are commonly misdiagnosed as having asthma. Due to the lack of recent data on Norwegian COPD diagnoses, we wished to assess the development of diagnosing and treating COPD and asthma in Norway.

We identified patients with an ICPC-diagnosis of COPD and/or asthma at eight primary health care centres in Norway, 1995 - 2004. Data on prescription of medical drugs, spirometry testing, visits to casualty/outpatient clinics, and hospitalization were retrieved from electronic sources.

The diagnosis COPD was used increasingly over the study period, while the the use of the asthma diagnosis declined in the oldest age-groups. The proportion of COPD patients tested with spirometry increased from 24 % (68/288) in 1995 - 96, to 41 % in 2003 - 04. 16 % of COPD patients were in contact with out-of-hours services, 19 % had an outpatient consultation, and 24 % were hospitalized the same calendar year as the diagnosis was given in general practice. Corresponding numbers for asthma patients were substantially lower.

The increased use of the COPD diagnosis indicates improved diagnostic routines, probably because of increased use of spirometry in primary care. Early and correct diagnosis contributes to more optimal use of medication and improved follow/up.