Office-Based Case Finding for Chronic Obstructive Pulmonary Disease in Older Adults in Primary Care Journal Articles uri icon

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abstract

  • Background. Chronic Obstructive Pulmonary Disease (COPD) is underdiagnosed in primary care.Aim. To explore the utility of proactive identification of COPD in patients 75 years of age and older in a Canadian primary care setting.Methods.Canadian Thoracic Society (CTS) screening questions were administered to patients with a smoking history of 20 pack-years or more; those with a positive screen were referred for postbronchodilator spirometry.Results. A total of 107 patients (21%), of 499 screened, had a 20-pack-year smoking history; 105 patients completed the CTS screening. Forty-four (42%) patients were positive on one or more questions on the screening; significantly more patients with a previous diagnosis of COPD (64%) were positive on the CTS compared to those without a previous diagnosis of COPD (30%). Of those who were not previously diagnosed with COPD (N= 11), four (36%) were newly diagnosed with COPD.Conclusion. A systematic two-stage method of screening for COPD, using CTS screening questions followed by spirometric confirmation, is feasible in the context of a busy primary care setting. More research is needed to assess the value of restricting screening to patients with a smoking history of 20 pack-years and on the sensitivity and specificity of these measures.

publication date

  • 2016