Spirometry use in clinical practice in patients with COPD

Lee TA, Bartle B, Weiss KB. Spirometry use in clinical practice in patients with COPD. Poster session presented at: American Thoracic Society Annual International Conference; 2005 May 1; San Diego, CA.

RATIONALE: Spirometry is used in COPD to make diagnoses, grade severity, evaluate medication response and monitor progression. The use of spirometry in the community setting has received much attention recently. Yet, little is known about the current use of spirometry in clinical practice. The objective of this analysis was to evaluate the use of spirometry in the Veterans Affairs (VA) healthcare system for patients with COPD. METHODS: We used VA administrative data to identify a cohort of patients 40 years of age and older with at least two COPD-related contacts (hospitalization, ED visit, outpatient visit) in Fiscal Year (FY) 1999 that were using VA healthcare services in FY1998 but did not have any COPD-related visits. We identified spirometry through procedure codes and VA clinic stop codes in FY1999. We compared the characteristics of those with and without a spirometry visit. RESULTS: We identified 197,878 patients meeting inclusion criteria. The average age was 67.5 years (SD = 10.0) and 98.2% were male. During the 12 month period, 60,590 patients (30.6%) had at least one spirometry. Patients with spirometry were younger, more likely to have a hospitalization, ED visit and pulmonologist visit, and had higher proportions treated with respiratory medications (Table). CONCLUSIONS: The minority of patients with a new COPD diagnosis had spirometry performed. These findings raise questions about the current use of spirometry and its role in the diagnosis and management of COPD patients.