Chronic Obstructive Pulmonary Disease Case Finding: Severity Grade at First Spirometry and Ongoing Therapy 12 Months...

Area of Science:

• Pulmonary Medicine
• Primary Care
• Respiratory Health

Background:

• Many Chronic Obstructive Pulmonary Disease (COPD) diagnoses occur at advanced stages (GOLD 3-4), despite the goal of early detection (GOLD 1).
• Early identification of COPD in at-risk individuals, particularly smokers, is a key strategic objective to improve patient outcomes and manage healthcare resources effectively.

Purpose of the Study:

• To assess the effectiveness of quality-controlled spirometry in primary care for early COPD diagnosis.
• To evaluate ongoing COPD therapy and medication adherence in patients diagnosed through this initiative.

Main Methods:

• An observational study (STructured Efficient E-Tracking, STREET project) enrolled 397 subjects with suspected COPD (post-bronchodilator FEV1/FVC <0.7).
• The study recorded ongoing COPD therapy and Medication Possession Ratio (MPR) at 12 months.

Main Results:

• Only 15% of enrolled subjects were diagnosed at GOLD 1 stage; approximately 80% were diagnosed at GOLD 2-3 stages.
• Inappropriate treatment was observed, with 21% of GOLD 2-3 patients receiving Long-Acting Beta Agonist/Inhaled Corticosteroid combinations without exacerbations.
• Medication adherence (MPR ≥80%) was low, detected in less than 30% of subjects across GOLD 1-3 stages.

Conclusions:

• The majority of COPD patients are diagnosed late (GOLD 2-3), indicating a failure in early detection strategies.
• A significant proportion of patients receive non-guideline-compliant treatments (LABA/ICS), suggesting a need for better physician education.
• Low adherence to prescribed therapies across all GOLD stages necessitates interventions to improve patient compliance and treatment effectiveness.