A new educational program on chronic obstructive pulmonary disease (COPD), launched by NPS MedicineWise in March, includes a reminder on the critical importance of spirometry in diagnosing the condition, which is estimated to affect 1.45 million Australians.
Spirometry is considered the best way to measure airflow limitation and according to NPS MedicineWise medical adviser Dr. Andrew Boyden is the “gold standard” for diagnosing COPD, yet local primary care studies shows that spirometry is vastly underutilised in Australia.
“COPD diagnosis requires demonstration of persistent airflow limitation which is not fully reversible,” said Dr. Boyden. “COPD can’t be diagnosed reliably on clinical features and/or chest X-ray alone.”
Misdiagnosis between asthma and COPD is common. Spirometry is useful in differentiating between the two.
“As separate entities asthma and COPD require different approaches to management. However, they can be difficult to differentiate on the basis of symptoms alone - and in some patients these conditions can overlap,” said Dr. Boyden.
“Spirometry helps to ensure that patients with COPD obtain an accurate diagnosis and receive appropriate treatments.”
According to Dr. Boyden, there are several reasons for the underuse of spirometry in Australia. These include time constraints, staffing issues, equipment quality and control, inadequate training and lack of confidence in interpreting data.
Accuracy and reliability of primary care spirometry depends on skills and training in both performing the test and interpreting results.
“Having a dedicated member of a practice – for example, a practice nurse – performing spirometry, is a good idea,” said Dr. Boyden. ‘This can help address time barriers for busy GPs.”
For GP practices without a spirometer, available options may include a respiratory laboratory, respiratory physician or pathology collection center. The procedure is reimbursable under the MBS.