title: Variability in the performing of spirometry and its consequences in the treatment of COPD in primary care.
abstract: BACKGROUND
  Several studies have approached the use of spirometry in the treatment of chronic obstructive pulmonary disease (COPD) in Primary Care (PC), but few have analysed its impact on the treatment of the patient with COPD.
  
  
  OBJECTIVE
  To evaluate the use of spirometry in the diagnosis and follow-up of COPD patients in PC, and its impact on treatment. To analyse the variation in the performing of spirometry between PC centres.
  
  
  METHODS
  A multicentre, observational and cross-sectional study of COPD patients seen in PC in Catalonia (Spain) during 2004-2005. A multilevel logistic regression model was used to identify factors associated with having spirometry and to determine the variation between the different centres.
  
  
  RESULTS
  Twenty-one centres which included 801 patients took part. Only 53.2% of them had a diagnostic spirometer available and the mean (standard deviation) FEV1(%) was 54.8% (18%). The registers of smoking habits, complementary tests and spirometry follow-up were more common among patients who had a diagnostic spirometry available compared to those who did not. No statistically significant differences were found as regards demographic, clinical, treatment and quality of life variables between patients with and without follow-up spirometry. Significant variation was observed in the percentage of diagnostic spirometries between different PC centres (variance=0.217; p<0.001).
  
  
  CONCLUSIONS
  Spirometry is underused in PC and performing it during follow-up is not associated to the different treatments received, or with a more complete approach to the disease. There is significant variation in the performing of spirometry among PC centres.
authors.affiliation: Área científica IDIAP Jordi Gol, Barcelona, España. mmonteagudo@idiapjgol.org
authors.forename: Mònica
authors.initials: M
authors.lastname: Monteagudo
authors.forename: Teresa
authors.initials: T
authors.lastname: Rodriguez-Blanco
authors.forename: Judith
authors.initials: J
authors.lastname: Parcet
authors.forename: Núria
authors.initials: N
authors.lastname: Peñalver
authors.forename: Carles
authors.initials: C
authors.lastname: Rubio
authors.forename: Montserrat
authors.initials: M
authors.lastname: Ferrer
authors.forename: Marc
authors.initials: M
authors.lastname: Miravitlles
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D011320:Primary Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000139:chemically induced* / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life; D013147:Spirometry / Q000379:methods