Reversibility test is helpful in COPD

Inclusion of reversibility testing in the COPD quality domain has been supported by UK research that showed one patient in five has reversible airflow obstruction.

COPD
COPD

The study involved 1,508 smokers or ex-smokers over 40 with respiratory problems who were referred to an open-access spirometry clinic by their GP.

It found that 53 per cent had pre-bronchodilator airflow obstruction. But reversibility testing performed on 469 of these patients demonstrated that 19.3 per cent were no longer obstructed post-bronchodilator.

Analysis of 235 patients with post-bronchodilator airflow obstruction showed that the number diagnosed with COPD increased from 63 to 139 after spirometry.

The tests resulted in a significant increase in the use of anticholinergics, long-acting beta- agonists and inhaled steroids.

Spirometry, including reversibility testing, to confirm a diagnosis of COPD is worth up to 10 points in the quality framework and patients who show reversibility should be transferred to the asthma register. However, NICE clinical guidance for COPD does not endorse the reversibility test.

Dr Steve Holmes, a GP in Somerset and chairman of the General Practice Airways Group, said the study finding ‘supports the need for reversibility testing’.

‘I would encourage my GP colleagues always to consider asthma,’ he said.

But Professor Martyn Partridge, a member of the British Thoracic Society executive committee, said: ‘There is a lot of confusion about why people do reversibility testing. If you are doing it for diagnosis of whether someone has asthma or COPD, it is useful.’

rachel.liddle@haymarket.com

Eur Respir J 2006; 28: 945-952

MIMS links

Asthma, COPD

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

Woman holding face in pain

Should GPs treat patients presenting with dental problems?

The MDU's Dr Kathryn Leask considers what GPs should do if a patient presents with...

Conservative Party leadership candidate and foreign secretary Liz Truss

Liz Truss vows to resolve GP pension tax crisis if she becomes prime minister

Liz Truss has affirmed her commitment to resolving the GP pensions crisis but has...

Baby receiving a vaccine in their thigh

JCVI advises changes to routine childhood and HPV immunisation schedules

The Joint Committee on Vaccination and Immunisation (JCVI) has recommended a change...

GP consultation

General practice delivering 'up to double the appointments it is paid for'

General practice in England may be delivering as many as double the number of appointments...

Sign outside BMA House

GP suicide sparks calls for measures to protect doctors from spiralling workloads

The government and policymakers must do more to safeguard doctors and NHS staff from...

Talking General Practice logo

Podcast: Living with long COVID

In August we’re bringing you some of the best interviews from series one of the podcast....