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Perspectives

Spirometry and COPD. The why, when and how

JULIA A.E. WALTERS, Peter Frith

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Abstract

Chronic obstructive pulmonary disease (COPD) is a common progressive and ultimately disabling condition. It is underdiagnosed, and late recognition leads to worse outcomes. Incorporating spirometry and case finding in primary care for those at risk of COPD can improve diagnosis.

Key Points

  • At least half of the burden of disease in chronic obstructive pulmonary disease (COPD) is not recognised with a doctor’s diagnosis.
  • The consequences of not diagnosing COPD include increased risk of exacerbations and pneumonia, increased hospitalisations and increased mortality.
  • Handheld devices can be used to screen at-risk patients to determine the need for spirometry.
  • A post-bronchodilator forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) of less than 0.7 is required to confirm the diagnosis of COPD.
  • Patients with a diagnosis of COPD, require regular, ongoing monitoring of FEV1 because treatment recommendations change with disease progression.

    Picture credit: © John Thys/Reporters/SPL
    Model used for illustrative purposes only

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