title: A comprehensive, national survey of spirometry in Spain: current bottlenecks and future directions in primary and secondary care.
abstract: BACKGROUND
  We aimed to evaluate the availability and practice of spirometry, training of technicians, and spirometer features and maintenance in Spain in both primary care (PC) and secondary care (SC) centers.
  
  
  METHODS
  We used a nationwide, cross-sectional, 36-item telephone survey of health-care centers in Spain to target the technician in charge of conducting spirometries in PC and SC centers where outpatient respiratory patients are routinely evaluated. The questions surveyed for resources, training, spirometer use, bronchodilator tests, and spirometer features and maintenance.
  
  
  RESULTS
  Of a total of 1,259 centers screened, 605 PC centers (21.2% of the PC centers in Spain) and 200 SC centers (24.9% of the SC centers in Spain) were surveyed. The response rate was 85.4% for PC centers and 75.1% for SC centers. All together, 19% of screened centers did not have a spirometer or were not using it. The number of spirometers per center and spirometries conducted per week was higher in SC centers than in PC centers (P &lt; .001). Most centers received training for conducting spirometries, but this was periodically done in &lt; 40%. Most centers used two inhalations of salbutamol for the bronchodilator test, but the international criteria of a positive test was considered only in 55.8% of PC and 52.8% of SC centers. Calibration of the spirometer was never done in 10.5% of PC and 3.1% of SC centers.
  
  
  CONCLUSIONS
  This survey maps for the first time, to our knowledge, the current situation of spirometry in Spain, identifying bottlenecks and suggesting future directions applicable in both PC and SC centers and elsewhere.
authors: Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBiS), Seville; Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid. Electronic address: lcampos@separ.es.
authors: Jose Luis
authors: JL
authors: López-Campos
authors: Fundación Caubet-Cimera Islas Baleares, Bunyola, Mallorca, Illes Balears.
authors: Joan B
authors: JB
authors: Soriano
authors: Servicio de Neumología, Hospital Universitario San Carlos, Madrid, Spain.
authors: Myriam
authors: M
authors: Calle
mesh_terms: D003430:Cross-Sectional Studies; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care; D015272:Pulmonary Medicine / Q000193:education*; D063127:Secondary Health Care; D013030:Spain; D013147:Spirometry / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires