RT Journal Article
SR Electronic
T1 Diagnosing asthma and COPD in primary care patients in Serbia: A multicenter study
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3694
VO 40
IS Suppl 56
A1 Marija Vukoja
A1 Predrag Rebic
A1 Zorica Lazic
A1 Marija Mitic Milikic
A1 Branislava Milenkovic
A1 Biljana Zvezdin
A1 Ivan Cekerevac
A1 Mirjana Jovancevic Drvenica
A1 Sanja Hromis
A1 Ivan Kopitovic
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P3694.abstract
AB BACKGROUND: Asthma and chronic obstructive pulmonary disease (COPD) are often unrecognized and undertreated.AIM: The aim of this study was to describe the frequency of COPD and asthma in patients with respiratory symptoms and/or smoking history in primary care settings in Serbia, and to examine the agreement between general practitioners (GPs) and pulmonologists on the diagnosis of COPD and asthma.METHODS: In this multicentric, prospective, observational study GPs from practices in 3 different centers in Serbia identified eligible patients from October 2009-Jun 2010. The study included all adult patients with respiratory symptoms and/or smoking history based on structured interview. The patients were referred to a pulmonologist and underwent a diagnostic work-up, including spirometry.RESULTS: There were 2074 patients, 38.4% men, mean age 54±15.5 years. Patients were mostly current (40.3%) or ex-smokers (27.4%). The common symptoms included shortness of breath (84.9%), cough (79.1%) and wheezing (64.3%). The COPD diagnosis was confirmed by pulmonologists in 454 (21.9%) and asthma in 455 (21.9%) patients. COPD was newly diagnosed in 226 (10.9 %) and asthma in 269 (13.0 %) of the cases. There was a moderate agreement between pulmonologists and GPs on the diagnosis of COPD (kappa 0.41, 95%CI 0.36-0.46) and asthma (kappa 0.42, 95% CI 0.37-0.465).CONCLUSION: A signicant number of patients seen in GPs office was diagnosed with COPD or asthma and half of them represent new cases. A substantial proportion of patients referred to pulmonologist by primary care physicians have been misdiagnosed.