The necessity for spirometry in the primary care management of COPD.
Implementation of spirometry in the primary care setting is controversial. Spirometry allows a unique non-invasive look into the functioning of the lungs, which can be both medically informative and of practical value. Respiratory complaints are among the most prevalent in primary care, while smoking rates remain globally high, illustrating the need for proper tools to investigate the possible causes of chronic pulmonary symptoms. Smoking cessation programs and disease management programs are the preferred treatment strategies for COPD; these rely on a valid spirometric diagnosis, as promoted by international COPD guidelines. In addition, involving the patient in treatment plans and explaining the detrimental effects of smoking can be greatly facilitated by the visual impact of a flow-volume curve, have promoted the use of spirometry. While there are difficulties in implementation of spirometry in primary care. Provided that quality standards of performance and training are sufficiently met, evidence suggests that spirometry is a valid, feasible and interpretable diagnostic tool in a primary care setting. COPD is a growing problem for society, which should not be underestimated, and with sufficient funding, adequate training and motivated healthcare workers, there is no good reason why spirometric testing cannot be widely implemented.
Chavannes
Niels
N
Department of General Practice, Caphri Research Institute, Maastricht University, 6229 HA Maastricht, The Netherlands.