Guideline-Based Early Detection of Chronic Obstructive Pulmonary Disease in Eight Danish Municipalities: The TOP-KOM Study.
Background. Early detection of chronic obstructive pulmonary disease (COPD) and prevention of disease progression are important. Only 40% of COPD cases are diagnosed in Denmark. Recommendations for early case finding have been established. This study investigates early detection of pulmonary obstruction in a Danish municipality setting.Methods. Eight municipalities participated. Citizens fulfilling national case finding recommendations, age ≥35 years, smokers/ex-smokers/relevant occupational exposure, and at least one respiratory symptom, were invited to spirometry. Citizens with indication of pulmonary obstruction, forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) < 0.70, were referred to their general practitioner (GP).Results. 1,499 citizens were examined (53.6% male, mean age 57.2 years). 44.8% were current smokers with 57% planning for smoking cessation. The citizens recorded significant airway symptoms with dyspnea being the most important (71%). The mean FEV1/FVC score was 73.54 (SD 22.84). 456 citizens (30.4%) were found to have indication for pulmonary obstruction and were referred to GP for further diagnosis.Conclusion. Early detection in Danish municipalities proved effective finding nearly 1/3 being pulmonary obstructive. It seems to be of value to have municipalities to perform case finding together with smoking cessation as a primary intervention in COPD management.
Municipality of Vordingborg, Health Secretariat, Langgade 57, 4780 Stege, Denmark.
Ulla Borup
UB
Hemmingsen
Municipality of Billund, Department of Health, Sydtoften 102, 7200 Grindsted, Denmark.
Margit
M
Stycke
Pfizer Denmark ApS, Lautrupvang 8, 2750 Ballerup, Denmark; Dmc Dollerup Medical Consultancy, Holmegårdsvej 49, 3100 Hornbæk, Denmark.
Jens
J
Dollerup
Pfizer Denmark ApS, Lautrupvang 8, 2750 Ballerup, Denmark.
Peter Bo
0000-0002-5279-4637
PB
Poulsen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark; D042241:Early Diagnosis; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000503:physiopathology; D012907:Smoking / Q000009:adverse effects / Q000503:physiopathology; D014797:Vital Capacity / Q000502:physiology