Spirometry utilisation among Danish adults initiating medication targeting obstructive lung disease

Area of Science:

• General Practice
• Respiratory Medicine
• Health Services Research

Background:

• Obstructive lung diseases are common, often presenting with symptoms like dyspnea, cough, and wheezing.
• Empirical treatment for obstructive lung disease is frequent, despite low predictive value of symptoms and spirometry's role as the gold standard.
• Lack of spirometry may lead to delayed diagnosis, unnecessary costs, and medication risks for patients.

Purpose of the Study:

• To assess spirometry utilization within one year of initiating obstructive lung disease medication.
• To examine associations between patient characteristics (socioeconomic, demographic) and spirometry testing.
• To investigate general practice characteristics linked to spirometry testing.

Main Methods:

• Observational, register-based studies of adult first-time users of obstructive lung disease medication in Denmark (2008).
• Patient cohorts identified via the Danish National Prescription Register; spirometry data from Danish National Health Service and Patient Registers (2007-2010).
• Analysis linked patient and practice variables to assess associations with spirometry performance.

Main Results:

• Approximately half of the 40,969 adult initiators of obstructive lung disease medication had spirometry performed.
• Factors increasing spirometry odds included initiating multiple medications and repeated redemptions.
• Reduced odds for spirometry were associated with female sex, older age, unemployment, living alone (elderly men), and increasing doctor age.

Conclusions:

• A significant underuse of spirometry testing exists among patients initiating medication for obstructive lung disease, signifying a quality gap.
• Variations in spirometry testing are primarily linked to patient and doctor age, with other factors showing smaller impacts.
• Identifying these variations can guide general practitioners in targeting interventions for improved spirometry utilization.