Regular spirometry not associated with benefits for asthma and/or COPD

January 01, 0001

Regular spirometry not associated with benefits for asthma and/or COPD

The aim of this study was to determine whether spirometry with regular medical review improves the quality of life or other health outcomes among patients with asthma or chronic obstructive pulmonary disease (COPD) managed in general practice. It consisted of a cluster randomised controlled trial conducted in 31 general practices in Melbourne, Australia during 2007-2008. Practices recruited 305 adult patients who had been prescribed inhaled medication in the preceding 6 months. Practices were randomly assigned to one of three groups: Group A patients received 3-monthly spirometry performed by a respiratory scientist with results returned to the practice and regular medical review; Group B patients received spirometry only before and after the trial; and Group C patients received usual care. The main outcome measure was Quality of life, assessed with the 36-item Short Form (SF-36) Australian (English) Version 2 questionnaire at baseline and 3, 6, 9 and 12 months. The trial was completed by 253 participants: 79 in Group A, 104 in Group B, and 70 in Group C. Median age was 58 years (range, 18-70 years), and 167 participants (66%) were women.

There were no significant changes in SF-36 Physical and Mental Component Summary scores from baseline to 12 months, or significant differences between groups on either scale or any subscale of the SF-36. There were also no significant differences in respiratory symptoms, asthma attacks, written asthma action plans, days lost from usual activities or health care utilisation.

The researchers concluded: "Three-monthly spirometry and regular medical reviews by general practitioners are not associated with any significant improvement in quality of life or other health outcomes for patients with asthma and/or COPD."

Spirometry may be a helpful tool for diagnosis, but not for monitoring.

For the full abstract, click here.

MJA 193(2):104-109, 19 July 2010
© The Medical Journal of Australia 2010
Do spirometry and regular follow-up improve health outcomes in general practice patients with asthma or COPD? A cluster randomised controlled trial. Michael J Abramson, Rosa L Schattner, Nabil D Sulaiman et al. Correspondence to Michael Abramson:

Category: R. Respiratory. Keywords: spirometry, regular follow-up, health, improve, general practice, asthma, COPD, cluster randomised controlled trial, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 6 August 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.