[Spirometry as method of screening and intervention in high- risk smokers in primary care]

Abstract

Objective: To show the effectiveness of screening in the detection of new cases of COPD in smokers of high-risk, and to describe the characteristics associated with COPD, as well as determine the predisposition to quit.

Design: A cross-sectional and multicentre study.

Location: Basic Primary Care Centres representing different rural and urban areas of Lleida.

Participants: A total of 497 active smokers without COPD from 40 to 70 years selected from the database Primary Care Database (e-CAP).

Intervention: Spirometry was performed on all patients. The spirometry results were reported and brief counselling was given on quitting smoking and the readiness to stop smoking was determined.

Variables: Age, gender, height, weight, smoking, respiratory symptoms and physical activity.

Results: The majority of patients (65.4%) were men, age 51± 7.6 years. They smoked an average of 32 packs/year; 40.4% performed moderate activity and 27.4% referred to some respiratory symptoms. Of the 25% who had an obstructive or mixed pattern, 75.8% of the cases had a moderate level of severity. A decision to quit was made by 38.8%. In the multivariate analysis, gender, age 50 to 59 years and a smoking index>40 were associated with COPD. Moderate or intense physical activity decreased the risk of COPD.

Conclusions: To perform spirometry in high-risk smokers, to show the spirometry results and give brief anti-smoking counselling, enables not previously diagnosed cases of COPD to be detected. It also helps to determine the readiness to stop smoking and to establish individualised treatment and follow-up plans.