Primary Care Providers’ Views on Using Lung Age as an Aid to Smoking Cessation Counseling for Patients with Chronic Obstructive Pulmonary Disease

Abstract

Purpose Smoking cessation is the primary goal for managing patients with chronic obstructive pulmonary disease (COPD) who smoke. However, previous studies have demonstrated poor cessation rates. The “lung age” concept (an estimate of the age at which the FEV1 would be considered normal) was developed to present spirometry data in an understandable format and to serve as a tool to encourage smokers to quit. Primary care physicians’ (PCPs) views of using lung age to help COPD patients to quit smoking were assessed. Methods Post-intervention interviews were conducted with PCPs in the U.S. who participated in the randomized clinical trial, “Translating the GOLD COPD Guidelines into Primary Care Practice.” Results 29 physicians completed the interview. Themes identified during interviews included: general usefulness of lung age for smoking cessation counseling, ease of understanding the concept, impact on patients’ thoughts of quitting smoking, and comparison to FEV1. Most providers found lung age easy to communicate. Moreover, some found the tool to be less judgmental for smoking cessation and others remarked on the merits of having a simple, tangible number to discuss with their patients. However, some expressed doubt over the long-term benefits of lung age and several others thought that there might be a potential backfire for healthy smokers if their lung age was ≤ to their chronological age. Conclusions This study suggests that lung age was well received by the majority of PCPs and appears feasible to use with COPD patients who smoke. However, further investigation in needed to explore COPD patients’ perspectives of obtaining their lung age to help motivate them to quit in randomized clinical trials.

Effects of Systematic Intervention for Chronic Obstructive Pulmonary Disease on Follow-up and Smoking Cessation Rates and Changes of the Pulmonary Function: A 7-year Longitudinal Study in a Japanese Rural City

“…The U.S. smoking cessation guidelines indicate that the smoking cessation rate can be improved nearly three-fold by increasing the time devoted to guidance in one session, total guidance time, and number of types of specialists providing guidance. In addition, we provided smoking cessation guidance and an incentive to cease smoking using lung age, as calculated by pulmonary function tests ( 30 ). Morris et al ( 31 ) and the U.S. Public Health Service ( 14 ) reported that repeated education by many healthcare professionals and feedback using lung age are effective strategies for encouraging continued treatment by patients with COPD.…”

Estimation of lung age via a spline method and its application in chronic respiratory diseases

“…Moreover, even though the FEV 1 of stage I COPD patients was numerically normal (FEV 1 %pred ≥80%), the Δ lung age values of 53% stage I COPD patients exceeded the ULN, indicating that lung age may be more helpful than FEV 1 %pred for patients to be aware of their lung function impairment. As lung age makes it easier for patients to understand their lung function level and is also well accepted by the majority of primary care physicians 17 , we believe that lung age may be a useful tool to be applied in the assessment and management of chronic respiratory diseases with lung function impairment, especially in primary care.…”

Self-Reported Smoking Status 10-Months After a Single Session Intervention Including an Education Conference About Smoking Harms and Announcement of Spirometric Lung-Age

“…12 Confronting smokers with their SLA has been used by general practitioners and primary care providers as a tool to encourage them to quit smoking. 13,14…”