Abstract
Background: Around 430,000 Danes suffer from chronic obstructive pulmonary disease (COPD) with one-third diagnosed today. Danish National Board of Health (NBH) recommends early detection of COPD, focusing on smokers/ex-smokers (or high-risk occupation) above 35 years with >1 respiratory symptom. Municipalities have been suggested to be responsible for early detection. A pilot study found early detection in municipalities to be feasible and reliable in terms of citizens ending up with the final diagnosis of COPD at their GP.
Aim and objective: To investigate the success of screening for COPD in eight Danish municipalities.
Methods: Eight municipalities (430,000 inhabitants) offered spirometry to citizens (self-referral) with no previous COPD diagnosis fulfilling the NBH criteria. Citizens with airway obstruction (fixed ratio: FEV1/FVC<70%) were requested to visit their GP for diagnosis. Data, including spirometry and smoking habits, were recorded in a secure database.
Results: 950 citizens in the risk group of COPD were included (55% females, 58 years, 45% smokers, 30 pack-years, 1-2 lung symptoms, MRC 1.6). Of the sample 34% (323) (22-44% in different municipalities) had indication of airway obstruction. Screening spirometry suggested 86% had mild to moderate COPD. With evidence from the pilot study: 85% detected by municipality screening end up diagnosed with COPD at their GP. This suggests that 29% (275) of the patients in the present sample were COPD patients. After screening 65% of smokers were interested in quitting smoking.
Conclusions: Early detection of COPD at the municipality level seems to be worthwhile and successful. Together with the GP-level this might identify undiagnosed COPD patients.
- © 2012 ERS
