RT Journal Article
SR Electronic
T1 Early detection of undiagnosed COPD in general practice; the yield of population-based screening according to socioeconomic status
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P263
VO 42
IS Suppl 57
A1 Joseph Dirven
A1 Huibert Tange
A1 Jean Muris
A1 Onno van Schayck
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P263.abstract
AB Background. The burden of chronic obstructive pulmonary disease (COPD) is high. Health benefits can be gained in primary care by early detection and preventive measures.Aim. To determine the effectiveness of a population-based screening procedure including a risk questionnaire and spirometry testing. To compare two strategies of providing this procedure in different socioeconomic settings.Method. A cluster-randomised controlled trial among all 40-70 years of age in 16 family practices. Practices were randomized on strategy and stratified on socioeconomic profile. The Respiratory Health Screening Questionnaire (RHSQ) was used. In the practice managed condition, the practice was responsible for the whole procedure. In the patient managed condition patients were responsible for calculating their RHSQ risk score and applying for a spirometry test. Main outcome measure was the rate of COPD diagnoses after screening.Results. In the practice-managed condition more new COPD patients were detected (36%) than in the patient-managed condition (18%). In low-SES practices more high-risk patients were found (16%) than in average-SES practices (9%). Recalculated for a standard Dutch practice (2250 patients) the yield would be 20% increase of known cases.Conclusion. The practice-managed variant of this screening procedure shows a substantial yield of new COPD diagnoses for both low-SES and average-SES practices.