Detection of chronic obstructive pulmonary disease (COPD) in primary health care: role of spirometry and respiratory symptoms

Objective - To evaluate the role of spirometry and respiratory symp toms in the detection of chronic obstructive pulmonary disease (COPD) in primary h ealth care. Design - A cross-sectional study. Setting - A primary health centre in Landskrona, southern Sweden. Subjects - 164 subjects who in 1992 had answered a postal questionnaire con cerning obstructive pulmonary diseases and respiratory symptoms. They were aged 45-64 years, with a mean of 55 years. Main outcome measures - In 1997, the subjects were invited to perform a spi rometry and a medical examination and to answer the same questionnaire as i n 1992. Subjects with a forced expiratory volume in I second (FEV1) < 85% o f the predicted normal value performed reversibility tests. Results - 131 subjects participated in the examinations. 15 subjects (11.5% ) were diagnosed as having COPD. Only three of them had been previously dia gnosed as having a respiratory disease. Many commonly occurring respiratory symptoms were associated with a reduction in FEV1. Conclusions - Spirometry examinations in primary health care improve the pr obability of detecting COPD. A spirometry examination should be considered for patients with respiratory symptoms, It should also be considered for mi ddle-aged smokers, even if they are symptom-free.