Spirometry in Greenland: a cross-sectional study on patients treated with medication targeting obstructive pulmonary disease

Abstract

BackgroundChronic obstructive pulmonary disease (COPD) is globally increasing in frequency and is expected to be the third largest cause of death by 2020. Smoking is the main risk factor of developing COPD. In Greenland, more than half of the adult population are daily smokers, and COPD may be common. International guidelines recommend the usage of spirometry as a golden standard for diagnosing COPD. The current number of spirometries performed among patients treated with medication targeting obstructive pulmonary disease in Greenland remains unexplored.ObjectiveTo estimate the prevalence of patients aged 50 years or above treated with medication targeting obstructive pulmonary disease and the extent to which spirometry was performed among them within 2 years.DesignAn observational, cross-sectional study based on the review of data obtained from electronic medical records in Greenland was performed. The inclusion criterion was that patients must have been permanent residents aged 50 years or above who had medication targeting obstructive pulmonary disease prescribed within a period of 15 months prior to data extraction. A full review of electronic patient records was done on each of the identified users of medication targeting obstructive pulmonary disease. Information on age, gender, town and spirometry was registered for each patient within the period from October 2013 to October 2015.ResultsThe prevalence of patients treated with medication targeting obstructive pulmonary disease aged 50 years or above was 7.9%. Of those, 34.8% had spirometry performed within 2 years and 50% had a forced expiratory volume (1 sec)/ forced vital capacity (FEV1/FVC) under 70% indicating obstructive pulmonary disease.ConclusionThe use of medication targeting obstructive pulmonary disease among patients over 50 years old is common in Greenland. About one third of the patients had a spirometry performed within 2 years. To further increase spirometry performance, it is recommended to explore possible barriers in health care professionals’ usage of spirometry in different health care settings in Greenland.

Prevalence and quality of care among patients using medication targeting obstructive lung disease: a cross-sectional study in the five regions of Greenland

“…The same percentage is expected for spirometry biannually. Furthermore, the proportion of patients having performed spirometry within 2 years were lower than the proportion in the previous study by Nielsen et al (34.8% versus 26.0% in this study) [6].…”

“…Since 2014, all consultations, including the hospital, health care centre and settlement consultation, have been registered in the same EMR [ 6 , 14 ].…”

“…Earlier studies have estimated a prevalence of COPD in Greenland and found a prevalence of patients treated with medication targeting obstructive lung disease aged 50 or above was 6.1% and 7.9% in 2013 and 2016, respectively [ 5 , 6 ]. A comparable prevalence (6.7%) of COPD was established for Canadian Inuit living in Ottawa in 2018, and other studies in Nordic countries have shown similar results [ 7–9 ].…”

“…The initiative included annual control of COPD patients and their digitally registered prescriptions, smoking status, spirometry results and other lifestyle factors. Although increasing from 2013 to 2016, the use of spirometry and diagnostic classification of COPD was reported suboptimal in Greenland [ 5 , 6 ]. A similar trend is seen in other countries, where use of spirometry has also been reported too low compared to guidelines [ 11 , 12 ].…”

Management of patients with obstructive lung disease in South India: a retrospective study of spirometry and bronchodilator use in an urban health centre

“…Our results are similar to the use of spirometry by general practitioners in the national survey in India and in Western countries. 14,15 Besides the reasons reported in earlier studies, the low rate of spirometry testing in a primary care setting in India can be attributed to the health care system in our country. 4 Unlike the urban health centre where spirometry was accessible though not available, primary health centres and secondary care hospitals in the public sector health system in India are not equipped with a spirometry or a system for accessing and interpreting the results of spirometry.…”