BMJ  2006;333:870-871 (28 October), doi:10.1136/bmj.38987.478727.80

Editorial

Spirometry in chronic obstructive pulmonary disease

Is available, yet underused in general practice

The first 150 words of the full text of this article appear below.

Chronic obstructive pulmonary disease affects about 1% of the total UK population¹ and is a major cause of disability and mortality worldwide. Timely diagnosis and subsequent staging of severity of disease both require spirometry, which in theory can be performed by trained general practitioners (GPs) and their practice staff.^{2 3} However, numerous barriers impede the implementation of spirometry in primary care.

Several guidelines exist for the management of patients with chronic obstructive pulmonary disease, including those from the UK National Institute for Health and Clinical excellence (NICE)⁴ and the Global Initiative for Chronic Obstructive Lung Disease (GOLD; www.goldcopd.com). All guidelines stress the central role of spirometry in diagnosing and managing the disease in primary care, but this does not guarantee that GPs will use this technique consistently in the care of patients with respiratory symptoms.⁵

Several models to provide spirometry test results exist, depending on local circumstances; these include . . . [Full text of this article]

Department of General Practice (117), Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, Netherlands
(p.j.p.poels@hag.umcn.nl)

Department of General Practice (117), Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, Netherlands

Department of Medicine, Clinical Sciences Centre, University Hospital Aintree, University of Liverpool, Liverpool L9 7AL

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• Walters, J A, Hansen, E C, Johns, D P, Blizzard, E L, Walters, E H, Wood-Baker, R (2008). A mixed methods study to compare models of spirometry delivery in primary care for patients at risk of COPD. Thorax 63: 408-414 [Abstract] [Full text]  
• Calverley, P. (2008). Fulfilling the promise of primary care spirometry. Eur Respir J 31: 8-10 [Full text]  
• Derom, E., van Weel, C., Liistro, G., Buffels, J., Schermer, T., Lammers, E., Wouters, E., Decramer, M. (2008). Primary care spirometry. Eur Respir J 31: 197-203 [Abstract] [Full text]  
• Poels, P. J. P., Schermer, T. R. J., Schellekens, D. P. A., Akkermans, R. P., de Vries Robbe, P. F., Kaplan, A., Bottema, B. J. A. M., van Weel, C. (2008). Impact of a spirometry expert system on general practitioners' decision making. Eur Respir J 31: 84-92 [Abstract] [Full text]  
• Poels, P. J. P., Schellekens, D. P. A., Schermer, T. R. (2007). Effect of spirometry on COPD management in primary care: where are the studies that we really need?. Eur Respir J 29: 820-820 [Full text]  

Rapid Responses:

Read all Rapid Responses

Competency-based training may facilitate confidence in community-based spirometry

Amit Patel
bmj.com, 30 Oct 2006 [Full text]

Motivations to spirometry beyond barriers

Takeharu Koga, et al.
bmj.com, 8 Nov 2006 [Full text]

COPD rates are higher

David M Syme
bmj.com, 13 Nov 2006 [Full text]