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Point of care microspirometry to facilitate the COPD diagnostic process in primary care: a clustered randomised trial



Tjard R Schermer, Maria Vatsolaki, Robbert Behr, et al.
npj Prim Care Respir Med 2018;28:17
doi: 10.1038/s41533-018-0083-9

Diagnostic spirometric confirmation of chronic obstructive pulmonary disease (COPD) takes more time to perform and interpret than that afforded by a GP consultation. GPs therefore lack objective information, resulting in COPD being underdiagnosed in primary care. Microspirometry, which measures forced expiratory volume in one second, could help GPs recognise airway obstruction in at-risk patients more easily before diagnostic spirometry testing is required. This could result in earlier diagnosis of COPD and more efficient use of full diagnostic spirometry testing.

This study explored the effect of introducing microspirometry in general practice as a point-of-care test for COPD. They conducted a 6–8-month clustered randomised controlled trial in 21 practices with 416 possibly undiagnosed COPD patients. In subjects identified as being at risk from COPD, the diagnostic process was completed and reported more often when the GP had a microspirometer available. In addition, use of diagnostic spirometry appeared to be more efficient in the microspirometry group. Although microspirometry improved the diagnostic process, the majority of possible undiagnosed COPD patients remained unrecognised by their GPs.




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