STUDY OBJECTIVES: To document the rate of diagnostic certainty, co-morbidity and use of medication in patients with presumed obstructive airway disease (OAD) in a primary care setting. METHODS: Twenty-six general practitioners (GPs) were asked to select the last 50 contacts with patients older than 40 years of age who were taking bronchodilators and/or inhaled corticosteroids or who had known OAD. After reviewing their medical data on file, the GPs gave their diagnostic opinion and rated their certainty about the diagnosis using a Likert-type scale. RESULTS: Analysis of 1126 files revealed that in at least 523 patients (46.4%), a diagnostic work-up was judged necessary. The GPs judged that 6% of the patients had no OAD. Less than 33% of the study population underwent spirometry during the two years preceding the survey. The number of co-morbid conditions was on average 2.2 for patients with asthma and 3.2 for patients with COPD. Patients with presumed COPD took significantly more drugs (mean, 5.1; 95% CI, 4.8-5.3) than did patients with other diagnostic labels (mean, 4.6 95%; CI, 4.4-4.8). CONCLUSIONS: We confirmed the underuse of spirometry as a diagnostic tool in presumed airway obstruction in primary care. Nearly half of the patients older than 40 years who were taking bronchodilators and/or inhaled corticosteroids needed a diagnostic work-up. This population had a high prevalence of co-morbidity and polypharmacy.
STUDY OBJECTIVES: To document the rate of diagnostic certainty, co-morbidity and use of medication in patients with presumed obstructive airway disease (OAD) in a primary care setting. METHODS: Twenty-six general practitioners (GPs) were asked to select the last 50 contacts with patients older than 40 years of age who were taking bronchodilators and/or inhaled corticosteroids or who had known OAD. After reviewing their medical data on file, the GPs gave their diagnostic opinion and rated their certainty about the diagnosis using a Likert-type scale. RESULTS: Analysis of 1126 files revealed that in at least 523 patients (46.4%), a diagnostic work-up was judged necessary. The GPs judged that 6% of the patients had no OAD. Less than 33% of the study population underwent spirometry during the two years preceding the survey. The number of co-morbid conditions was on average 2.2 for patients with asthma and 3.2 for patients with COPD. Patients with presumed COPD took significantly more drugs (mean, 5.1; 95% CI, 4.8-5.3) than did patients with other diagnostic labels (mean, 4.6 95%; CI, 4.4-4.8). CONCLUSIONS: We confirmed the underuse of spirometry as a diagnostic tool in presumed airway obstruction in primary care. Nearly half of the patients older than 40 years who were taking bronchodilators and/or inhaled corticosteroids needed a diagnostic work-up. This population had a high prevalence of co-morbidity and polypharmacy.
Authors: Claudio M Sanguinetti; Nicolino Ambrosino; Filippo Andò; Fernando De Benedetto; Claudio F Donner; Stefano Nardini; Mario Polverino; Roberto Torchio; Guido Vagheggini; Alberto Visconti Journal: Multidiscip Respir Med Date: 2014-12-18
Authors: Marietta Rottenkolber; Eef Voogd; Liset van Dijk; Paola Primatesta; Claudia Becker; Raymond Schlienger; Mark C H de Groot; Yolanda Alvarez; Julie Durand; Jim Slattery; Ana Afonso; Gema Requena; Miguel Gil; Arturo Alvarez; Ulrik Hesse; Roman Gerlach; Joerg Hasford; Rainald Fischer; Olaf H Klungel; Sven Schmiedl Journal: PLoS One Date: 2015-02-23 Impact factor: 3.240
Authors: Luis García-Olmos; Angel Alberquilla; Victoria Ayala; Pilar García-Sagredo; Leticia Morales; Montserrat Carmona; María José de Tena-Dávila; Mario Pascual; Adolfo Muñoz; Carlos H Salvador; Jose L Monteagudo Journal: BMC Fam Pract Date: 2013-01-16 Impact factor: 2.497
Authors: Nicolas Roche; Céline Pribil; Eric Van Ganse; Philippe Serrier; Bruno Housset; Déborah Poirier; Nathalie Texier; Stéphane Schück; Isabelle Boucot Journal: BMC Pulm Med Date: 2014-04-02 Impact factor: 3.317
Authors: Claudio M Sanguinetti; Fernando De Benedetto; Claudio F Donner; Stefano Nardini; Alberto Visconti Journal: Multidiscip Respir Med Date: 2014-06-12