Why is it important to diagnose COPD, and use spirometry, if the patient has no symptoms chronically and has quit smoking? Unless something has changed recently, the medications currently available for COPD treat symptoms; they do not change the natural course of the disease. If doing a moderately expensive test does not change management, why do it?
Missed Opportunities to Diagnose COPD Earlier Detailed — Physician’s First Watch
Missed Opportunities to Diagnose COPD Earlier Detailed
By Joe Elia
An examination of the clinical records of some 40,000 patients with chronic obstructive pulmonary disease shows plenty of missed opportunities to make the diagnosis (and intervene) earlier.
Data on the patients came from U.K. national databases for the period 1990 through 2009. Some 85% of patients diagnosed with COPD had a visit related to lower-respiratory symptoms in the 5 years before the diagnosis was made, according to research in the Lancet Respiratory Medicine. Most of those consultations resulted in a prescription, most often for antibiotics or steroids.
The authors recommend that COPD should be considered, and spirometry done, in patients over 40 with a history of smoking who present with lower-respiratory symptoms. It should also be considered in patients with smoking histories who are attending clinics for comorbid conditions often associated with COPD, such as cardiovascular disease or diabetes.