Inter-regional changes in the performance and interpretation of spirometry in Spain: 3E study

Abstract

Objectives: This report shows the results of a nation-wide survey on spirometry to assess regional differences.

Methods: Observational cross-sectional study conducted by means of a telephone survey in 805 primary care (PC) and specialized centers (SC) in all regions. The survey contacted technicians in charge of spirometry and consisted of 36 questions related to the test.

Results: The results showed major differences between regions. Most centers had 1-2 spirometers. The number of spirometry tests per week ranged from 2 to 8.9 in PC and between 34.3 and 98.3 in SC. Some training had been given in most centers (63.6-100% in PC and 60.0-100% in SC) but not on a regular basis. Most centers used several short-acting bronchodilators for the bronchodilation test, but with insufficient inhalations (2.0-3.8 in PC and 2.0-3.3 in SC) and frequently incorrect waiting time (29.4-83.3% PC and 33.3-87.5% in SC). Daily calibration was not performed in all centers (0-100% in PC and 66.7-100% in SC). Significant inter-regional differences in spirometry quality criteria were observed, with 6 or more criteria met in 9.1-84.6% of PC centers and 37.5-100% in SC.

Conclusions: Our results show the current situation of spirometry in primary and specialized care in Spain, highlighting considerable variability and areas for improvement. This information should be considered by health officials to improve the quality and accessibility of such tests.

Keywords: Asma; Asthma; Bronchodilator test; Calidad; Chronic obstructive pulmonary disease; Enfermedad pulmonar obstructiva crónica; Espirometría; Prueba broncodilatadora; Quality; Spirometry.