Detection of airflow limitation using a handheld spirometer in a primary care setting

Area of Science:

• Pulmonary Medicine
• Primary Care Diagnostics
• Epidemiology

Background:

• Early diagnosis of chronic obstructive pulmonary disease (COPD) in primary care is hindered by limited spirometry access.
• This study addresses the need for accessible diagnostic tools in primary care settings for smokers.

Purpose of the Study:

• To estimate the prevalence of airflow limitation in chronic smokers using a handheld spirometer in a primary care setting.
• To identify predictors of airflow limitation in this patient population.

Main Methods:

• A cross-sectional study involving 416 patients aged ≥40 with ≥10 pack-years smoking history.
• Data collected via face-to-face interviews and handheld spirometry (COPd-6) alongside standard spirometry.
• Airflow limitation defined by FEV1/FEV6 <0.75 or FEV1/FVC <0.7; logistic regression used for predictor analysis.

Main Results:

• Prevalence of airflow limitation was 10.6% using handheld spirometry (COPd-6) versus 6% with standard spirometry.
• Significant risk factors for airflow limitation included age >65 years (OR 3.732), history of 'bad health' (OR 2.524), and low to normal BMI (OR 2.914).

Conclusions:

• Handheld spirometry (COPd-6) in primary care detected approximately 10% prevalence of airflow limitation among smokers.
• Older age, lower BMI, and a history of health issues are associated with airflow limitation in this cohort.