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Type: Journal article
Title: Feasibility and efficacy of COPD case finding by practice nurses
Author: Bunker, J.
Hermiz, O.
Zwar, N.
Dennis, S.
Vagholkar, S.
Crockett, A.
Marks, G.
Citation: Australian Family Physician, 2009; 38(10):826-830
Publisher: Royal Australian College of General Practitioners
Issue Date: 2009
ISSN: 0300-8495
Statement of
Jeremy Bunker, Oshana Hermiz, Nicholas Zwar, Sarah M. Dennis, Sanjyot Vagholkar, Alan Crockett, Guy Marks
Abstract: BACKGROUND Chronic obstructive pulmonary disease (COPD) is a leading cause of disability, hospital admission and premature mortality, but is often undiagnosed. This study assessed the effectiveness, feasibility and acceptability of COPD case finding by practice nurses performing spirometry on patients identified as being at risk of developing COPD. METHODS Practice nurses were trained in spirometry. From four general practices, 1010 patients were identified who were aged 40–80 years and current or ex-smokers. Four hundred were randomised to receive a written invitation to attend a case finding appointment with the practice nurse, including spirometry. RESULTS Seventy-nine patients attended, 16 (20.3% of attendees) had COPD diagnosed on spirometry; practice nurses correctly identified 10 of the 16, but also incorrectly identified a further six patients as having COPD. One patient in the usual care group was diagnosed with COPD, but this was not confirmed on spirometry. DISCUSSION This study confirmed that COPD is underdiagnosed, with 20% of those at risk and attending for screening having COPD. The search strategy successfully identified patients at risk. Further training in spirometry would be required for practice nurses to increase the accuracy of the diagnoses. The opportunity cost would require consideration. The acceptability to patients is also an issue, this may be related to the recruitment method or the intervention. This study also does not answer whether earlier diagnosis in these patients leads to any change in outcomes.
Keywords: Humans
Pulmonary Disease, Chronic Obstructive
Mass Screening
Multivariate Analysis
Logistic Models
Risk Assessment
Feasibility Studies
Family Practice
Clinical Competence
Aged, 80 and over
Middle Aged
Nursing Staff
New South Wales
Rights: © Copyright The Royal Australian College of General Practitioners. All rights reserved.
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Appears in Collections:Aurora harvest
General Practice publications

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