title: Delay in diagnosis of chronic obstructive pulmonary disease: reasons and solutions.
abstract: OBJECTIVE
  Chronic obstructive pulmonary disease (COPD) is a crippling disease with a high worldwide prevalence. It is the fifth-leading cause of death worldwide and estimated to become the third-leading cause of death by 2030. This review highlights recent studies that discuss reasons for and possible solutions to the delay in diagnosis of COPD.
  
  
  RESULTS
  Delay in COPD diagnosis is multifactorial and can be grouped into healthcare provider-related factors, patient-related factors, and heterogeneity in the disease itself. The current literature strongly supports the lack of awareness and knowledge about COPD among healthcare providers as an important factor in misdiagnosis and/or delays in diagnosis. Ironically, COPD is both underdiagnosed and overdiagnosed.
  
  
  CONCLUSIONS
  Achieving the goal of early diagnosis in COPD needs a major overhaul and culture change in primary care settings. Respiratory symptoms in a smoker 40 years or above should trigger automatic health alert and spirometry indications. Awareness of tobacco-related injury is the first building block in prevention and cure.
authors.affiliation: aPulmonary and Critical Care Division, University of Arkansas for Medical Sciences bCentral Arkansas Veterans Healthcare System, Little Rock, Arkansas, USA.
authors.forename: Rajani
authors.initials: R
authors.lastname: Jagana
authors.forename: Thaddeus
authors.initials: T
authors.lastname: Bartter
authors.forename: Manish
authors.initials: M
authors.lastname: Joshi
mesh_terms: D042241:Early Diagnosis; D006801:Humans; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D013147:Spirometry; D013577:Syndrome