MedWire News: Opportunistic testing by trained, visiting nurses improves spirometry compared with usual care, but fails to increase chronic obstructive pulmonary disease (COPD) diagnosis, a study indicates.
The results, reported in advance online by the journal Thorax, showed that COPD remained substantially underdiagnosed despite a significantly greater proportion of individuals at risk for COPD being tested and better techniques being applied with the opportunistic approach.
Spirometry is essential for the diagnosis of COPD, but presents difficulties in primary care, such as lack of access to reliable equipment, lack of training, patients' reluctance to travel, and financial disincentives, note Julia Walters (University of Tasmania, Australia) and team.
The researchers tested the impact of opportunistic spirometry by trained nurses on recognition of airflow obstruction in a 6-month study conducted at eight primary care practices.
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MedWire News: Patients with severe chronic obstructive pulmonary disease (COPD) can attain peak oxygen consumption after 5 to 9 minutes of symptom-limited maximal cardiopulmonary exercise testing (CPET), as opposed to the 8 to 12 minutes proposed in the current guidelines, US research shows.
"These results may have important implications for the clinical application of CPET as it is commonly applied to patients with severe COPD," the authors write in the journal Chest."
CPET is often used in patients with COPD to tailor exercise prescriptions in pulmonary rehabilitation, evaluate responses to an intervention2, and aid in the construction of prediction rules for defining risk.
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Reprinted with kind permission from MedWire News
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