Volume 19 Issue 2 June 2010Original Research
Patient-reported respiratory symptoms and prebronchodilator
airflow limitation among smokers in
Switzerland
Pages 163-169
#David Miedingera,b, #Anette Linza, Claudia Praehausera, Prashant N Chhajeda, Christian Buessc, Salome Schafroth Töröka, Heiner C Bucherb, Michael Tamma, *Jörg D Leuppia
# Joint first authors
a
Pulmonary Medicine, Department of Internal Medicine, University Hospital, Basel, Switzerland
b
Basel Institute for Clinical Epidemiology, University Hospital, Basel, Switzerland
c
ndd Medizintechnik AG, Zürich, Switzerland
Received 14 July 2009 • Accepted 6 April 2010 • Online 28 May 2010
Abstract
AIMS: To evaluate the prevalence and predictors of airflow limitation among smokers aged >40 years visiting primary care practices in
Switzerland, and the correlation between airflow limitation and patient-reported symptoms.
METHODS: General practitioners (GPs) were invited to participate in the study via letter. Airflow limitation was measured using an
EasyOne™ spirometer without administration of a bronchodilator, and patient-reported symptoms were evaluated using an intervieweradministered
questionnaire.
RESULTS: 15,084 subjects recruited by 440 GPs had acceptable quality spirometry traces; 8,031 of these (53%) had symptom data available
and were included in this analysis. Only 18.5% of the GP consultations were for respiratory reasons. In total, 29% of individuals had prebronchodilator
airflow limitation suggesting chronic obstructive pulmonary disease according to the Global Initiative for Chronic
Obstructive Lung Disease (GOLD)/Hardie interpretation. The interviewer-administered questionnaire indicated that 58% of individuals had
at least one current symptom – cough, sputum production, or dyspnoea. There were no differences in lung function for patients answering
yes or no to symptom questions.
CONCLUSIONS: Pre-bronchodilator airflow limitation and patient-reported respiratory symptoms are frequent among smokers, but short
dichotomous questions about symptoms are not useful for identifying patients with airflow limitation. Spirometry can identify patients
with early airflow limitation in general practice. However, poor quality of spirometry, even with an automated feedback and quality
control spirometer, remains an issue.
Keywords
Smoking, general practice, chronic obstructive pulmonary disease, airflow limitation, spirometry, patient-reported symptoms
* Corresponding author. Jörg D Leuppi Tel: +41 61 265 25 25 Fax: +41 61 265 53 53 Email: leuppij@uhbs.ch | |
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