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Spirometry can be done in family physicians’ offices and alters clinical decisions in management of asthma and COPD

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From Māori Health Review Issue 10
Authors:
  • Yawn BP et al
Summary:

This study sought to determine the technical adequacy of spirometry results, concordance between family physician and pulmonary expert interpretations of spirometry test results, and changes in asthma and chronic obstructive pulmonary disease (COPD) management following spirometry testing in primary care, using outcomes from 368 spirometry tests completed over a 6-month period. These tests involved 382 patients with asthma and COPD and staff from 12 family medicine practices across the US. A total of 71% of the tests were technically adequate for interpretation. Concordance between family physician and pulmonary expert interpretations of test results was observed in 76% of tests; concordance was higher for patients with asthma than for those with COPD. Changes in management occurred in 48% of patients following spirometry testing, including 107 medication changes (>85% concordant with guideline recommendations) and 102 nonpharmacological changes.

Comment:
Asthma and COPD are significant health issues for Mäori and therefore some practices, on reading this paper, may want to undertake spirometry on site. For such providers, there are a number of options. At our practice, we had a GP with respiratory training undertake the spirometry, interpret results and discuss management with the referring GP. Others have a respiratory worker (normally nurse or physiotherapist) visit, particularly during winter, and run spirometry clinics. Finally, formal or informal training can be provided at regional hospitals.
Reference: Chest. 2007;132:1162-8
Abstract
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Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

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