Have you ever had a spirometry lung function test? New research shows that most patients are diagnosed with COPD based only on their symptoms.
Chronic obstructive pulmonary disease (COPD) is a term that encompasses chronic bronchitis and emphysema. The symptoms of COPD develop slowly over many several years and include wheezing, a chronic cough that produces phlegm, and progressive shortness of breath. COPD is the fourth leading cause of death in the United States.
In a recent study reported in the journal Chest (Volume 129, page 1509 ) researchers found that lung function tests are underused in the diagnosis of COPD. Only one third of patients recently diagnosed with COPD undergo the recommended lung function testing, according to a study of almost 200,000 patients.
The findings, based on data collection beginning in 1999, suggest that most patients involved were diagnosed with COPD based only on symptoms, even though national guidelines recommend spirometry lung function testing to diagnose and manage COPD. (Spirometry is the measurement of the volume of air forcefully exhaled by the lungs as a function of time.).
Researchers studied data from 197,878 patients, average age 67.5, with COPD. Most of the COPD patients (98.2%) were men. Only 66,744 (33.7%) underwent spirometry. Spirometry use for newly diagnosed COPD patients decreased with age and was 3.3 times higher for those visiting pulmonologists. Only 21.4% of patients who had acute flare-ups of COPD had spirometry. Current guidelines recommend spirometry four to six weeks after an exacerbation. Among patients undergoing anesthesia for surgery, spirometry rates were much higher: 85.5% had the test in the month before surgery.
Some study participants were treated before new guidelines about spirometry were published. Still, physicians may not order the test because they either don’t know about it or don’t believe it is effective. If you have been diagnosed with COPD but have never had spirometry, ask your doctor about it.
