Chest
Clinical InvestigationsMiscellaneousSpirometry in Primary Care Practice: The Importance of Quality Assurance and the Impact of Spirometry Workshops
Section snippets
Participants
A randomized, controlled prospective study was performedto examine the quality of practice. Practitioners were invited to participate by an introductory letter, sent to 301 primary care practices; 119 of 301 practices (40%)accepted. Thirty of 119 practices (25%), each nominating one doctorand one nurse, were randomly selected to make up the final studygroup. Local ethics committee approval was obtained.
Three separate evaluations were performed:
- 1.
Spirometry quality (using ATS criteria) was
Results
A total of 1,012 patient tests (2,928 blows) were performed. The mean number (SD) of patient tests per practice per week was 2.3(2.4). Patient demographic data included the following: meanage, 46.0 years (range, 5 to 90 years); and patientswere equally divided by gender (male/female ratio, 1:0.98). Themajority of patients were either white (83%) or Maori/Pacific Islander(12.5%), reflecting the ethnic distribution in the Auckland region.
Discussion
This is the first study to formally address the quality ofspirometry performed in primary care practice. Spirometry performed inclinical primary care practice did not generally satisfy ATS criteriafor acceptability and reproducibility, both before and after formaltraining, although a significant training effect was observed. Is itpossible the ATS criteria are unnecessarily rigorous? Published datawould suggest not. The Lung Health Study demonstrated that in only2.1% of test sessions were
ACKNOWLEDGMENT
The authors are grateful to Dr. J Kolbe for hisvalued advice on manuscript preparation.
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2021, Respiratory MedicineCitation Excerpt :However, in studies in which follow-up training was applied, technically correct examinations were found in most patients [25,26,28]. Similarly, all except one study [21] in which spirometry training courses were conducted by respiratory healthcare professionals achieved relatively high rates of technically correct examinations [21–29]. This might be because experienced clinicians can pass on their clinical knowledge from years of practice.
This study was supported by a grant from the Northern Regional HealthAuthority and the Asser Trust.