A study published in the Medical Journal of Australia has
found that many patients with chronic obstructive pulmonary disease (COPD) are
being incorrectly diagnosed.
COPD is a major cause of mortality, morbidity and health
services use. It is the seventh leading cause of burden of disease in Australia and is the fourth-leading cause of
death for men and the sixth for women, Prof Nicholas Zwar from the University of New South Wales and colleagues said.
"We found that there are substantial rates of misdiagnosis
of COPD in primary care, with less than 60 per cent of patients having the
clinical diagnosis confirmed on spirometry," Prof Zwar said.
Spirometry is a pulmonary function test that measures the
greatest volume of air that can be breathed out in the first second of a large
breath and in a whole large breath, and it is essential for accurate diagnosis
"This has important implications for management, including
using medicines to treat COPD in patients who do not have the condition.
"Until an alternative to spirometry is found, there is a
need to develop and evaluate strategies to encourage its use and improve its
quality in the diagnostic process of patients seen in general practice.
The low level of remuneration received for performing
spirometry, and the availability of appropriately trained workforce to perform
spirometry in primary care are issues, Prof Zwar said.
"An approach arising from this study could be to prioritise
patients with comorbidities for thorough diagnostic assessment, including
spirometry, as this group may be more likely to be incorrectly diagnosed.
"There is also a need to better understand the nature and
causes of respiratory symptoms in patients in general practice.
The Medical Journal of Australia is a publication of the
Australian Medical Association.