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Feasibility and efficacy of COPD case finding by practice nurses
Jeremy Bunker1, Oshana Hermiz, Nicholas Zwar
1South West Area Health Service, and Conjoint Lecturer, School of Public Health and Community Medicine, University of New South Wales. jeremyb@sigpet.com.au
Australian Family Physician
|November 7, 2009
Summary
Chronic obstructive pulmonary disease (COPD) is underdiagnosed, with 20% of at-risk patients diagnosed via practice nurse spirometry. Further training is needed to improve diagnostic accuracy for this common respiratory condition.
Area of Science:
- Pulmonary Medicine
- Primary Care
Background:
- Chronic obstructive pulmonary disease (COPD) is a significant cause of morbidity and mortality, frequently remaining undiagnosed.
- Early detection of COPD is crucial for timely intervention and improved patient outcomes.
Purpose of the Study:
- To evaluate the effectiveness, feasibility, and patient acceptability of COPD case finding by practice nurses using spirometry.
- To identify individuals at risk for developing COPD in a primary care setting.
Main Methods:
- Practice nurses received spirometry training.
- 1010 at-risk patients (aged 40-80, current/ex-smokers) were identified across four general practices.
- 400 patients were invited for spirometry-based case finding appointments.
Main Results:
- 79 patients attended the case-finding appointments.
- Spirometry diagnosed COPD in 16 attendees (20.3%).
- Practice nurses demonstrated moderate accuracy in COPD diagnosis, with a need for improved precision.
Conclusions:
- COPD is significantly underdiagnosed in at-risk populations.
- Practice nurse-led spirometry is a feasible approach for COPD case finding.
- Enhanced training for nurses and consideration of patient recruitment strategies are necessary to optimize COPD screening programs.
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