Abstract
Background: COPD is frequently undiagnosed especially in socio-economically deprived (SED) populations who are most at risk of this condition.
Aims: To improve access to hard to reach groups
To identify those most at risk of having undiagnosed COPD and to signpost to general practice for further assessment
Methods: A mobile health bus was sited in areas of high SED with good footfall and accessibility. Nurses trained to recognise COPD syptoms, perform FEV6 micro-spirometry and experienced in informal, non-medicalised approaches to health and disease staffed the bus. High risk individuals (over 35 yrs, smoker or ex-smoker with symptoms suggestive of COPD) were targeted for FEV6 micro-spirometry. Consent was gained to share all results with own GP. Those with unexplained respiratory symptoms and/or abnormal FEV6 readings were asked to see their GP for further assessment. Follow up with patient experience survey took place 8 weeks after a visit to the bus.
Results: The bus visited 6 sites on 7 occasions. 350 people visited the bus, between 6% and 87% of contacts were from areas of high SED. Of 119 in the high risk group, 67% men and 45% females had symptoms suggesting COPD and of those suitable for FEV6 readings 30% of men and 38% women had airflow obstruction: all were signposted to their GP. 48% were current smokers. Data from the experience survey indicates that many suspected something was wrong; accessibility and convenience prompted them to come forward for testing.
Conclusion: Our pilot work suggests that mobile units in non-clinical settings can increase accessibility to SED groups and prompt high risk individuals to be tested for COPD. Further work is needed.
- © 2011 ERS