Thorax 1999;54:501-505 ( June )

Screening older patients for obstructive airways disease in a semi-rural practice

J A Dickinson, M Meaker, M Searle, G Ratcliffe

Central Surgery, King Street, Barton on Humber, North Lincolnshire DN18 5ER, UK

Correspondence to: Dr J A Dickinson.

Received 1 June 1998; Returned to authors 27 July 1998; Revised version received 26 January 1999; Accepted for publication 29 January 1999

BACKGROUNDObstructive airways disease in older patients is reported to be not only common, but frequently overlooked and untreated by general practitioners. This study examines the value of screening elderly patients in a large semi-rural general practice for potentially treatable asthma and chronic obstructive pulmonary disease (COPD).
METHODSA random sample of 353 patients aged 60-75 years attended a nurse run screening clinic for pulmonary function testing, serial peak flow recording, and completion of a symptom questionnaire. Patients with a low forced expiratory volume in one second (below the fifth centile of their predicted value) or >15% mean diurnal variation in peak flow were referred to a doctor's clinic for further diagnostic assessment and/or to discuss possible treatment where appropriate.
RESULTSFifty eight patients (16.4%) had obstructive airways disease, the prevalence of asthma being 6.5% and that of COPD 9.9%. Of these, 30 had no previous diagnosis of airways disease and were not on treatment; eight of them had significant airways reversibility and 10 were current smokers. No newly diagnosed patients had severe disease as measured by pulmonary function or quality of life assessment, and six patients accepted treatment.
CONCLUSIONFew older patients benefited from a screening programme for obstructive airways disease in a semi-rural general practice.


Keywords: asthma; chronic obstructive pulmonary disease; screening; geriatrics; general practice

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© 1999 by Thorax
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