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

NHS operating procedure for primary care to remain until UK lifts all COVID-19 restrictions

NHS operating procedure for primary care to remain until UK lifts all COVID-19 restrictions

The NHS standard operating procedure (SOP) for primary care will remain in place...

All adults in England to book COVID jab 'this week' as UK hits 30m second doses

All adults in England to book COVID jab 'this week' as UK hits 30m second doses

All adults should be able to book their first COVID-19 jab by the ‘end of this week’...

NHS faces workforce 'pinch point' as COVID-19 drives wave of retirements, warns GMC

NHS faces workforce 'pinch point' as COVID-19 drives wave of retirements, warns GMC

Numbers of doctors working in the NHS will soon reach a ‘pinch point’ unless immediate...

UK COVID-19 vaccination programme tracker

UK COVID-19 vaccination programme tracker

GPs across the UK are playing a leading role in the largest-ever NHS vaccination...

NHS England pledges £30m for GPs to boost long COVID diagnosis and care

NHS England pledges £30m for GPs to boost long COVID diagnosis and care

NHS England has promised £30m for general practice to improve diagnosis and care...

Second dose COVID jabs for over-40s to be accelerated as lifting restrictions is delayed

Second dose COVID jabs for over-40s to be accelerated as lifting restrictions is delayed

Second doses of COVID-19 vaccines in England will be 'accelerated' for all over-40s...