One in six in study had undiagnosed COPD

A new study involving current and former heavy smokers suggests that COPD is being systematically misdiagnosed

The researchers, from Monash University, set out to review the accuracy of diagnoses of COPD in primary care in Australia and to describe smokers’ experiences with and preferences for smoking cessation. The study was published in the MJA.

They identified more than 1000 current and former heavy smokers from 41 Melbourne general practices, including those who had a history of COPD (n=245).

They found, based on spirometry, that one third of the participants with a history of COPD (91 of 245) were misdiagnosed as having the respiratory disease, resulting in them receiving treatment for a disease they did not have – and in the meantime, actual underlying pulmonary conditions such as asthma were not appropriately treated.

A further one in six of the participants who did not have a diagnosis of COPD – 142 of 805 – in fact did have the disease.

The authors suggested that case finding and effective use of spirometry testing could improve diagnosis.

Lead author Dr Johnson George, from the Monash Centre for Medicine Use and Safety, says it’s a concern that this group of COPD sufferers had been undiagnosed.

“It’s important to diagnose COPD early so that the patient can be encouraged to give up smoking and appropriate pharmacological and non-pharmacological interventions, such as pulmonary rehabilitation, can be initiated,” he said.

“For many the diagnosis is incentive enough to try to stop smoking.”

The study also found that of the 690 participants who were current smokers, 360 had attempted to quit during the previous 12 months, but 286 (81% of those who tried to quit) had experienced difficulties during previous quit attempts.

Nicotine replacement therapy (205, or 65.7%) and varenicline (110, or 30.8%) were the most frequently employed pharmacological treatments, and side effects were common.

Hypnotherapy was the most popular non-pharmacological option (62 smokers, 17%) while e-cigarettes were tried by 38 (11%).

Of the current smokers, 27.6% said they would consider using e-cigarettes in future attempts to quit.

The authors suggest that health professionals should emphasise evidence-based treatments, and closely monitor quitting difficulties and side-effects of quitting aids.

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