Chest Infections: Respiratory Care |

Adherence to GOLD Guidelines: Is Spirometry Being Done in Primary Care Settings? FREE TO VIEW

Stephen Eikermann, DO; Timothy Murphy, DO; David Vanderheiden, DO; Antonio Guzman, MD; Salim Surani, MD
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Corpus Christi Medical Center, Corpus Christi, TX

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):155A. doi:10.1016/j.chest.2016.08.164
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SESSION TITLE: Respiratory Care

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: COPD is the 3rd leading cause of death in the United States and over 12 million people live with COPD. It is also estimated that almost 50% of them remain undiagnosed. It results in a burden of $36 billion in direct health care costs and in 2020 they are projected to increase to $49 billion. With the COPD readmission penalty in place, an erroneous diagnosis of COPD may have a significant financial risk. We undertook the study to assess the accuracy of diagnosis and utilization of spirometry in the primary care clinic.

METHODS: After approval from the local IRB, retrospective chart review was conducted in a primary care clinic of a community hospital. Baseline demographic data, COPD exacerbations, tobacco pack year history, usage of home oxygen, availability of spirometry, and the objective diagnosis of COPD were assessed.

RESULTS: Chart reviews of 65 patients were completed (50.77% female, 49.23% male). The average age of patients was 70.27 (+/-10.88) years and average BMI was 29.53 (+/-8.79). Patients smoked an average of 33.84 pack/years (+/-30.92). 33.84% were still smoking although 20% of patients were on home oxygen (13/65). Only 29% of the subjects have undergone spirometry or have the results available. Surprisingly, 31.6% of the patients with spirometry and the diagnosis of COPD in their records do not meet the diagnostic criteria for COPD by having an FEV1/FVC of less than 70%.

CONCLUSIONS: Utilization of spirometry remains suboptimal among the primary care clinic. Moreover, 31.6% of the patients with spirometry are mislabeled to have COPD.

CLINICAL IMPLICATIONS: Education at multiple levels and possible development of a software application need to be considered to improve compliance and patient care.

DISCLOSURE: The following authors have nothing to disclose: Stephen Eikermann, Timothy Murphy, David Vanderheiden, Antonio Guzman, Salim Surani

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