Enrico Heffler1, Claudia Crimi2, Salvatore Mancuso3, Raffaele Campisi4, Francesca Puggioni5, Luisa Brussino6, Nunzio Crimi4. 1. Personalized Medicine, Asthma and Allergy, Humanitas Research Hospital, Via Alessandro Manzoni 56, Rozzano, MI, Italy; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, MI, Italy. Electronic address: heffler.enrico@gmail.com. 2. Allergy and Respiratory Diseases, University of Catania, AOU Policlinico "Vittorio Emanuele", Via Santa Sofia 78, Catania, Italy. 3. Ricerca & Respiro ONLUS, AOU Policlinico "Vittorio Emanuele", Via Santa Sofia 78, Catania, Italy. 4. Allergy and Respiratory Diseases, University of Catania, AOU Policlinico "Vittorio Emanuele", Via Santa Sofia 78, Catania, Italy; Ricerca & Respiro ONLUS, AOU Policlinico "Vittorio Emanuele", Via Santa Sofia 78, Catania, Italy. 5. Personalized Medicine, Asthma and Allergy, Humanitas Research Hospital, Via Alessandro Manzoni 56, Rozzano, MI, Italy; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, MI, Italy. 6. Allergy and Clinical Immunology, University of Torino, AO "Ordine Mauriziano Umberto I", Corso Turati 62, Torino, Italy.
Abstract
BACKGROUND: The diagnosis of both asthma and chronic obstructive pulmonary disease (COPD) consists of a combination of classical symptoms and signs, and the evidence of consistent lung function abnormalities. Spiromety has been reported to be underused, possibly for practical difficulties in accessing to a lung function lab. This may lead to misdiagnosis of both asthma and COPD. We aimed to evaluate the frequency of spirometry use and the concordance between doctor-diagnosed asthma and COPD and spirometric patterns, in an unselected cohort of patients sent by general practitioners to perform a spirometry. METHODS: The first 300 patients consecutively enrolled patients performed spirometry and bronchodilator test with salbutamol 400 mcg. Demographic, clinical and lung function data have been collected. RESULTS: 128 patients (42.7%) declared a doctor-diagnosed asthma and 75 (25%) a doctor-diagnosis of COPD; the remaining subjects never had received any respiratory diagnosis. Only 112 patients with doctor-diagnosed asthma (55.2%) and 114 (56.2%) with doctor-diagnosed COPD have ever performed a spirometry in their entire life (average time since the last spirometry was about 47.0 months). Eighty-nine (69.5%) and 10 (13.3%) patients with respectively doctor-diagnosed asthma and COPD had concordant spirometric patterns with their known diseases. DISCUSSION: we described a worrying lack of use of spirometry and a high proportion of misdiagnosis, in patients with suspect chronic airway inflammatory diseases and cared by primary care physicians. Novel strategies to overcome this situation include should be implemented to give a better care to our patients.
BACKGROUND: The diagnosis of both asthma and chronic obstructive pulmonary disease (COPD) consists of a combination of classical symptoms and signs, and the evidence of consistent lung function abnormalities. Spiromety has been reported to be underused, possibly for practical difficulties in accessing to a lung function lab. This may lead to misdiagnosis of both asthma and COPD. We aimed to evaluate the frequency of spirometry use and the concordance between doctor-diagnosed asthma and COPD and spirometric patterns, in an unselected cohort of patients sent by general practitioners to perform a spirometry. METHODS: The first 300 patients consecutively enrolled patients performed spirometry and bronchodilator test with salbutamol 400 mcg. Demographic, clinical and lung function data have been collected. RESULTS: 128 patients (42.7%) declared a doctor-diagnosed asthma and 75 (25%) a doctor-diagnosis of COPD; the remaining subjects never had received any respiratory diagnosis. Only 112 patients with doctor-diagnosed asthma (55.2%) and 114 (56.2%) with doctor-diagnosed COPD have ever performed a spirometry in their entire life (average time since the last spirometry was about 47.0 months). Eighty-nine (69.5%) and 10 (13.3%) patients with respectively doctor-diagnosed asthma and COPD had concordant spirometric patterns with their known diseases. DISCUSSION: we described a worrying lack of use of spirometry and a high proportion of misdiagnosis, in patients with suspect chronic airway inflammatory diseases and cared by primary care physicians. Novel strategies to overcome this situation include should be implemented to give a better care to our patients.
Authors: Wan-Chun Huang; Greg J Fox; Ngoc Yen Pham; Thu Anh Nguyen; Van Giap Vu; Viet Nhung Nguyen; Stephen Jan; Joel Negin; Quy Chau Ngo; Guy B Marks Journal: PLoS One Date: 2022-07-11 Impact factor: 3.752
Authors: Enrico Heffler; Aikaterini Detoraki; Marco Contoli; Alberto Papi; Giovanni Paoletti; Giacomo Malipiero; Luisa Brussino; Claudia Crimi; Daniela Morrone; Marianna Padovani; Giuseppe Guida; Alberto Giovanni Gerli; Stefano Centanni; Gianenrico Senna; Pierluigi Paggiaro; Francesco Blasi; Giorgio Walter Canonica Journal: Allergy Date: 2021-03 Impact factor: 13.146