Knowledge and use of office spirometry for the detection of chronic obstructive pulmonary disease by primary care physicians.
BACKGROUND
The importance of office spirometry has been strongly advocated in the pulmonary community, but whether its importance is recognized and accepted by primary care physicians is less well established.


METHODS
To assess primary care physicians' knowledge and use of office spirometry for the detection of chronic obstructive pulmonary disease, we conducted a brief mail survey on the local practice of office spirometry, barriers to performing office spirometry, and general knowledge about spirometry. We also provided 60-min educational workshops to assess whether such an approach would increase spirometry testing or perceptions about spirometry.


RESULTS
Twenty-nine of 57 (51%) primary care offices responded to the survey. Of these, 66% owned their own spirometer. The most common reasons for not performing spirometry were uncertainty about the impact of the test (41%), physician and staff unfamiliarity (38%), and lack of training (34%). Twenty-one respondents participated in the workshops. In the 3 months following the workshops, the number of spirometry tests increased by 59% (p = 0.004). After the workshops, the proportion of clinics that reported reasons for not performing the test decreased by 13% (p = 0.01), but important barriers to performing office spirometry were still present, including physician and staff unfamiliarity (22%), uncertain interpretation of results (22%), time (22%), and reimbursement (22%).


CONCLUSIONS
The general knowledge and use of office spirometry in the primary care community is poor, but can be improved, at least in the short-term, by a simple educational workshop.
Kaminsky
David A
DA
Fletcher Allen Health Care, University of Vermont College of Medicine, Burlington, 05405, USA. david.kaminsky@uvm.edu
Marcy
Theodore W
TW
Bachand
Mark
M
Irvin
Charles G
CG
D002983:Clinical Competence; D005240:Feasibility Studies; D019538:Health Care Surveys; D006801:Humans; D007318:Inservice Training; D010865:Pilot Projects; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis*; D013147:Spirometry / Q000706:statistics & numerical data*