Following the publication of national guidelines on the management of chronic obstructive pulmonary disease in adults in primary and secondary care in 2004, there has been a steady rise in spirometry in primary care in the United Kingdom (UK), but little is known about the quality and understanding of the test in this setting.
We assessed the first 40 spirometry data provided by primary care physicians regarding new patients referred to all respiratory clinics at Milton Keynes Hospital, providing specialist respiratory services to a district of about 264000 people, since 1st Oct 2007. The data was considered to be complete if the measured and predicted values of Forced Expiratory Volume in 1 second (FEV1) and Forced Vital Capacity (FVC) were provided or if a computer-generated spirogram tracing was supplied.
Out of the 40 spirometry results, only 15 (38%) were complete out of which 13 (33%) had the spirogram tracings. In letters on 10 (25%) patients, the percentage predicted FEV1 confused with FEV1/FVC ratio. The calculation of the FEV1/FVC ratio was at all possible in 19 (48%).
Our results show incomplete spirometry data in 62% patients referred to a specialist respiratory clinic from primary care, probably reflecting limited understanding of spirometry in primary care.
It is encouraging that spirometry is being increasingly performed primary care, as early identification of lung function abnormalities can lead to improved health interventions, previous studies showing that fewer than half of primary care physicians use a spirometer regularly. However, the majority of spirometry data supplied from primary care are incomplete and reflect little understanding of the test as evident from not only the lack of completeness but also the confusion of the percentage predicted FEV1 with the FEV1/FVC ratio. There seems to be a wide scope for education on spirometry in primary care in the UK, particularly as the government has financially incentivised the performance of the test in that setting.
Ajikumar Kavidasan, No Financial Disclosure Information; No Product/Research Disclosure Information