Variation in spirometry utilization between trained general practitioners in practices equipped with a spirometer.
OBJECTIVE
To explore spirometry utilization among general practitioners and identify practitioner and practice-related factors associated with spirometry utilization.


METHODS
Multivariate multilevel cross-sectional analysis of a questionnaire survey.


METHODS
Some 61 general practices involved in a spirometry evaluation programme in the Netherlands. All practices owned a spirometer and were trained to perform spirometry.


METHODS
A total of 144 general practitioners and 179 practice assistants.


METHODS
Extent of spirometry utilization for five indications from national COPD/asthma guidelines, practitioner and practice-related factors associated with spirometry utilization.


RESULTS
The response rate was 97%. General practitioners used spirometry mostly to evaluate treatment with inhaled steroids (58%). Significant practitioner-related factors associated with spirometry utilization were: general practitioners' job satisfaction, general practitioners' general interest in research, and prior participation in spirometry training. Practice-related factors associated with spirometry utilization were: presence of a practice nurse, delegation of medical tasks to practice assistants, use of spirometry in different rooms, and use of protocols in practice.


CONCLUSIONS
Practitioner- as well as practice-related factors were associated with the extent of spirometry utilization. In particular, it is essential to improve practice-related factors (e.g. presence of a practice nurse, more delegation of medical tasks to the practice assistant).
Poels
Patrick J P
PJ
Department of General Practice, Radboud University Nijmegen Medical Centre, The Netherlands. p.j.p.poels@haf.umcn.nl
Schermer
Tjard R J
TR
Jacobs
Annelies
A
Akkermans
Reinier P
RP
Hartman
Joliet
J
Bottema
Ben J A M
BJ
van Weel
Chris
C
D000328:Adult; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010818:Practice Patterns, Physicians'; D011331:Private Practice; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D013147:Spirometry / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D000078329:Workforce