TY - JOUR T1 - Over-diagnosis of COPD in UK primary care JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P1212 AU - Wai Yee James AU - David Jolliffe AU - Kamrul Islam AU - Christopher Griffiths AU - Adrian Martineau Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P1212.abstract N2 - BackgroundMis-diagnosis of COPD was reported to be common in Australia primary care practice. We conducted a study to evaluate the frequency of this problem in United Kingdom primary care.ObjectivesTo determine the prevalence and correlates of mis-diagnosis of COPD and associated prescribing in UK primary care.MethodsThe records of COPD patients registered with 47 General Practices in London were searched electronically to identify patients with a ≥15 pack year of smoking history and age group of ≥40.Spirometry was performed on those who were consented in the Trial of Vitamin D supplementation study, and the characteristics of those who met ATS/ERS spirometric criteria for COPD (FEV1/FVC ratio <70%) were compared with those who did not. Normal spirometry was defined as predicted FEV1 ≥80%, predicted FVC ≥ 80% and FEV1/FVC ratio >70%. The prescription among patients who did not meet these criteria was assessed.ResultsA total of 264 patients were screened, of whom 232 (87.9%) were confirmed to have COPD by spirometric criteria and 32(12.1%) were not. 10/32 had evidence of restrictive lung disease and 22/32 had normal spirometry. 6/32 patients wrongly diagnosed with COPD were prescribed respiratory medication: 11/32 were prescribed tiotropium, 13/32 were prescribed a combination inhaler (LABA & ICS); 5/32 were prescribed inhaled corticosteroids, 2/32 were prescribed Xanthine, 21/32 were prescribed inhaled short acting brochodilator.ConclusionsMisdiagnosis of COPD is common in UK primary care and it is associated with a significant degree of inappropriate prescribed respiratory medication. Tackling this problem has the potential to prevent needless adverse effects of non-indicated therapy, and to save costs of inappropriate prescribing. ER -