Chronic obstructive pulmonary disease is being incorrectly diagnosed

COPD is a major cause of mortality, morbidity and health services use. It is the seventh leading cause of burden of disease in Australia and is the fourth-leading cause of death for men and the sixth for women, Prof Nicholas Zwar from the University of New South Wales and colleagues said.

“We found that there are substantial rates of misdiagnosis of COPD in primary care, with less than 60 per cent of patients having the clinical diagnosis confirmed on spirometry,” Prof Zwar said.

Spirometry is a pulmonary function test that measures the greatest volume of air that can be breathed out in the first second of a large breath and in a whole large breath, and it is essential for accurate diagnosis of COPD.

“This has important implications for management, including using medicines to treat COPD in patients who do not have the condition.

“Until an alternative to spirometry is found, there is a need to develop and evaluate strategies to encourage its use and improve its quality in the diagnostic process of patients seen in general practice.

The low level of remuneration received for performing spirometry, and the availability of appropriately trained workforce to perform spirometry in primary care are issues, Prof Zwar said.

“An approach arising from this study could be to prioritise patients with comorbidities for thorough diagnostic assessment, including spirometry, as this group may be more likely to be incorrectly diagnosed.

“There is also a need to better understand the nature and causes of respiratory symptoms in patients in general practice.

The Medical Journal of Australia is a publication of the Australian Medical Association.

The statements or opinions that are expressed in the MJA  reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.

CONTACT:     Prof Nicholas Zwar                              0417 063 061