Spirometry quality points should be phased out

Spirometry measurements for COPD should be phased out of the quality framework and replaced by symptom measurements, say respiratory experts.

Replace spirometry quality points
Replace spirometry quality points

Seventeen of a possible 33 quality points awarded for care of COPD patients are for spirometry measures to diagnose and monitor the condition.

The General Practice Airways Group (GPIAG) is recommending the 2008/9 quality framework takes account of the Medical Research Council dyspnoea score every 15 months.

This approach would be a better indicator of disease severity and would help tailor treatment to individuals, said Kent GP and GPIAG member Dr Hilary Pinnock who helped compile the group's proposal.

Spirometry is important for diagnosing COPD and distinguishing it from asthma, but its value at 15-month check-ups is less certain.

'We're suggesting that annual spirometry might be more often than is needed,' she said. ‘We suggest reducing the frequency of spirometry measurements.

'This is good clinical care as recommended by the British Thoracic Society (BTS)/SIGN guidelines and NICE.'

GPIAG recommendations  on asthma and COPD are to be built into a consensus alongside the British Thoracic Society and Educators for Health, after the organisations made similar proposals to the quality framework review board.

In May, respiratory charities will meet the quality framework review board to discuss the changes. Changes are scheduled to be finalised by negotiators by November, although this looks unlikely.

'What we're really trying to do is to appreciate that one size doesn't fit all,' said Dr Pinnock.

GPIAG wants asthma reviews to be extended to include an assessment of adequate control to help tailor care to individuals.

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