Identifying airway obstruction in primary care: is there a role for physiotherapists?
Abstract Aims To examine the implementation of a physiotherapist-driven spirometry case finding service in primary care to identify new cases of COPD and confirm diagnosis of existing cases of COPD. Methods Four general practices were recruited. ‘At risk’ participants (aged ≥ 40 years, current/ex-sm...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | BMC Primary Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12875-022-01944-z |
| _version_ | 1811291552794804224 |
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| author | Lisa Pagano Sarah Dennis Sally Wootton Sriram Mahadev Andrew S. L. Chan Nicholas Zwar Deborah Pallavicini Zoe McKeough |
| author_facet | Lisa Pagano Sarah Dennis Sally Wootton Sriram Mahadev Andrew S. L. Chan Nicholas Zwar Deborah Pallavicini Zoe McKeough |
| author_sort | Lisa Pagano |
| collection | DOAJ |
| description | Abstract Aims To examine the implementation of a physiotherapist-driven spirometry case finding service in primary care to identify new cases of COPD and confirm diagnosis of existing cases of COPD. Methods Four general practices were recruited. ‘At risk’ participants (aged ≥ 40 years, current/ex-smoker) and people with ‘existing’ COPD were identified from practice databases and invited to attend an assessment with a cardiorespiratory physiotherapist in each general practice. The physiotherapist performed pre/post-bronchodilator spirometry to identify or confirm a diagnosis of COPD (FEV1/FVC < 0.7). Outcome measures included number (%) of new cases of COPD, number (%) confirmed diagnosis of COPD and number (%) of high quality spirometry assessments with accurate interpretation. Results One hundred forty eight participants (mean age 70 years (SD 11.1), 57% female) attended a baseline assessment (117 ‘at risk’, 31’existing’ COPD) from 748 people invited. Physiotherapists performed 145 pre/post bronchodilator spirometry assessments. Obstruction on post-bronchodilator spirometry was confirmed in 17% (19/114) of ‘at risk’ and 77% (24/31) of ‘existing’ COPD. Majority of cases were classified as GOLD Stage II (63%, n = 27). Quality of pre/post bronchodilator spirometries for FEV1 were classified as A (68%), B (19%) and C (5%). Conclusion Physiotherapists integrated into primary care performed high quality spirometry testing, successfully case finding ‘at risk’ patients and identifying potential misdiagnosis of obstruction in some ‘existing’ COPD cases. Trial registration ANZCTR, ACTRN12619001127190. Registered 12 August 2019 – Retrospectively registered, http://www.ANZCTR.org.au/ACTRN12619001127190.aspx |
| first_indexed | 2024-04-13T04:31:04Z |
| format | Article |
| id | doaj.art-28e304b969d446f19abb1a8c777ad700 |
| institution | Directory Open Access Journal |
| issn | 2731-4553 |
| language | English |
| last_indexed | 2024-04-13T04:31:04Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Primary Care |
| spelling | doaj.art-28e304b969d446f19abb1a8c777ad7002022-12-22T03:02:18ZengBMCBMC Primary Care2731-45532022-12-012311910.1186/s12875-022-01944-zIdentifying airway obstruction in primary care: is there a role for physiotherapists?Lisa Pagano0Sarah Dennis1Sally Wootton2Sriram Mahadev3Andrew S. L. Chan4Nicholas Zwar5Deborah Pallavicini6Zoe McKeough7Sydney School of Health Sciences, Faculty of Medicine and Health, Level 7, D18 - Susan Wakil Health Building, The University of SydneySydney School of Health Sciences, Faculty of Medicine and Health, Level 7, D18 - Susan Wakil Health Building, The University of SydneySydney School of Health Sciences, Faculty of Medicine and Health, Level 7, D18 - Susan Wakil Health Building, The University of SydneyChronic Disease Community Rehabilitation Service, Northern Sydney Local Health DistrictChronic Disease Community Rehabilitation Service, Northern Sydney Local Health DistrictFaculty of Health Sciences and Medicine, Bond UniversitySydney North Primary Health NetworkSydney School of Health Sciences, Faculty of Medicine and Health, Level 7, D18 - Susan Wakil Health Building, The University of SydneyAbstract Aims To examine the implementation of a physiotherapist-driven spirometry case finding service in primary care to identify new cases of COPD and confirm diagnosis of existing cases of COPD. Methods Four general practices were recruited. ‘At risk’ participants (aged ≥ 40 years, current/ex-smoker) and people with ‘existing’ COPD were identified from practice databases and invited to attend an assessment with a cardiorespiratory physiotherapist in each general practice. The physiotherapist performed pre/post-bronchodilator spirometry to identify or confirm a diagnosis of COPD (FEV1/FVC < 0.7). Outcome measures included number (%) of new cases of COPD, number (%) confirmed diagnosis of COPD and number (%) of high quality spirometry assessments with accurate interpretation. Results One hundred forty eight participants (mean age 70 years (SD 11.1), 57% female) attended a baseline assessment (117 ‘at risk’, 31’existing’ COPD) from 748 people invited. Physiotherapists performed 145 pre/post bronchodilator spirometry assessments. Obstruction on post-bronchodilator spirometry was confirmed in 17% (19/114) of ‘at risk’ and 77% (24/31) of ‘existing’ COPD. Majority of cases were classified as GOLD Stage II (63%, n = 27). Quality of pre/post bronchodilator spirometries for FEV1 were classified as A (68%), B (19%) and C (5%). Conclusion Physiotherapists integrated into primary care performed high quality spirometry testing, successfully case finding ‘at risk’ patients and identifying potential misdiagnosis of obstruction in some ‘existing’ COPD cases. Trial registration ANZCTR, ACTRN12619001127190. Registered 12 August 2019 – Retrospectively registered, http://www.ANZCTR.org.au/ACTRN12619001127190.aspxhttps://doi.org/10.1186/s12875-022-01944-zCOPDPrimary careAllied healthDiagnosisSpirometry |
| spellingShingle | Lisa Pagano Sarah Dennis Sally Wootton Sriram Mahadev Andrew S. L. Chan Nicholas Zwar Deborah Pallavicini Zoe McKeough Identifying airway obstruction in primary care: is there a role for physiotherapists? BMC Primary Care COPD Primary care Allied health Diagnosis Spirometry |
| title | Identifying airway obstruction in primary care: is there a role for physiotherapists? |
| title_full | Identifying airway obstruction in primary care: is there a role for physiotherapists? |
| title_fullStr | Identifying airway obstruction in primary care: is there a role for physiotherapists? |
| title_full_unstemmed | Identifying airway obstruction in primary care: is there a role for physiotherapists? |
| title_short | Identifying airway obstruction in primary care: is there a role for physiotherapists? |
| title_sort | identifying airway obstruction in primary care is there a role for physiotherapists |
| topic | COPD Primary care Allied health Diagnosis Spirometry |
| url | https://doi.org/10.1186/s12875-022-01944-z |
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