title: Spirometry in Greenland: a cross-sectional study on patients treated with medication targeting obstructive pulmonary disease.
abstract: Chronic obstructive pulmonary disease (COPD) is globally increasing in frequency and is expected to be the third largest cause of death by 2020. Smoking is the main risk factor of developing COPD. In Greenland, more than half of the adult population are daily smokers, and COPD may be common. International guidelines recommend the usage of spirometry as a golden standard for diagnosing COPD. The current number of spirometries performed among patients treated with medication targeting obstructive pulmonary disease in Greenland remains unexplored.
  
  
  
  To estimate the prevalence of patients aged 50 years or above treated with medication targeting obstructive pulmonary disease and the extent to which spirometry was performed among them within 2 years.
  
  
  
  An observational, cross-sectional study based on the review of data obtained from electronic medical records in Greenland was performed. The inclusion criterion was that patients must have been permanent residents aged 50 years or above who had medication targeting obstructive pulmonary disease prescribed within a period of 15 months prior to data extraction. A full review of electronic patient records was done on each of the identified users of medication targeting obstructive pulmonary disease. Information on age, gender, town and spirometry was registered for each patient within the period from October 2013 to October 2015.
  
  
  
  The prevalence of patients treated with medication targeting obstructive pulmonary disease aged 50 years or above was 7.9%. Of those, 34.8% had spirometry performed within 2 years and 50% had a forced expiratory volume (1 sec)/ forced vital capacity (FEV1/FVC) under 70% indicating obstructive pulmonary disease.
  
  
  
  The use of medication targeting obstructive pulmonary disease among patients over 50 years old is common in Greenland. About one third of the patients had a spirometry performed within 2 years. To further increase spirometry performance, it is recommended to explore possible barriers in health care professionals' usage of spirometry in different health care settings in Greenland.
authors.affiliation: Queen Ingrid Primary Health Care Center, Nuuk, Greenland; lasse.overballe@gmail.com.
authors.forename: Lasse Overballe
authors.initials: LO
authors.lastname: Nielsen
authors.affiliation: Department of Pulmonology, Nordland Hospital, Bodø, Norway.
authors.forename: Sequssuna
authors.initials: S
authors.lastname: Olsen
authors.affiliation: Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
authors.forename: Dorte Ejg
authors.initials: DE
authors.lastname: Jarbøl
authors.affiliation: Queen Ingrid Primary Health Care Center, Nuuk, Greenland.|Greenland Center for Health Research, Institute of Nursing and Health Science, University of Greenland, Nuuk, Greenland.
authors.forename: Michael Lynge
authors.initials: ML
authors.lastname: Pedersen
mesh_terms: D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005260:Female; D005541:Forced Expiratory Volume; D006116:Greenland / Q000453:epidemiology; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care; D012042:Registries; D013147:Spirometry
keywords: COPD; Greenland; cross-sectional study; practice; primary; spirometry