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Provide GPs with spirometry, not spirometers
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  1. Paul Enright
  1. Dr Paul Enright, University of Arizona, 4460 East Ina Rd, Tucson, AZ 85718, USA; lungguy{at}aol.com

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Investigators from Tasmania, an island state of Australia (famous for its marsupial devils), have demonstrated, in this issue of Thorax,1 that both the quantity and quality of spirometry tests provided by nurses visiting general practitioner (GP) offices were much better than when GPs were given a spirometer and taught when and how to use it (see page 408). The visiting (peripatetic or itinerant) nurses tested 59% of the target group of ever smokers over the age of 35 years, compared with only 8% tested by the GPs with their own spirometer. Quality goals for spirometry were met by 76% of the tests done by the nurses but only by 44% of the tests done by the GPs.

In this issue of Thorax, a study is described in which investigators from Poland2 offered spirometry testing by visiting nurses to all 2250 adult patients over the age of 39 years in the practice of a single GP (see page 402). Over 87% of the target group responded by scheduling a visit to the office for spirometry testing. Post-bronchodilator (post-BD) spirometry was done for those with airway obstruction pre-BD. Quality goals for spirometry were met for 92% of the tests. Post-BD airway obstruction, consistent with chronic obstructive pulmonary disease (COPD), was detected in 9% of …

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