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Barriers to the use of spirometry in general practice


Walters, JAE and Hansen, EC and Mudge, P and Johns, DP and Walters, EH and Wood-Baker, R, Barriers to the use of spirometry in general practice, Australian Family Physician, 34, (3) pp. 201-203. ISSN 0300-8495 (2005) [Refereed Article]


BACKGROUND: Guidelines advise chronic obstructive pulmonary disease (COPD) should be diagnosed and managed by using spirometry to demonstrate irreversible airflow limitation and monitor change in smokers and ex-smokers aged over 35 years. METHODS: A cross-sectional study of patients and their general practitioners investigating use of spirometry in COPD in two practices by lung function assessment, review of practice records, interviews and focus groups. RESULTS: Sixteen GPs, and 38 patients with a diagnosis of COPD participated. At diagnosis, although 72% had spirometry, this occurred in only 41% of 17 patients diagnosed by a GP; but in all 19 cases when a specialist was involved. Diagnosis often occurred late, despite all patients having previously recorded symptoms typical of COPD. General practitioners expressed a preference to diagnose COPD on clinical grounds. Although 58% of patients had recent spirometry for current management, only 32% were performed by their GP. There were organisational and technical barriers to spirometry and poor recognition of the essential role of spirometry in the diagnosis of COPD. DISCUSSION: There are a number of potentially reversible factors that hinder practice recommendations regarding the use of spirometry in general practice to diagnose and manage COPD.

Item Details

Item Type:Refereed Article
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Respiratory diseases
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Walters, JAE (Dr Julia Walters)
UTAS Author:Hansen, EC (Dr Emily Hansen)
UTAS Author:Mudge, P (Professor Peter Mudge)
UTAS Author:Johns, DP (Associate Professor David Johns)
UTAS Author:Walters, EH (Professor Haydn Walters)
UTAS Author:Wood-Baker, R (Professor Richard Wood-Baker)
ID Code:37201
Year Published:2005
Deposited By:Medicine
Deposited On:2005-08-01
Last Modified:2009-08-20

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