Chest
Original ResearchA Randomized Controlled Trial on Office Spirometry in Asthma and COPD in Standard General Practice: Data From Spirometry in Asthma and COPD: a Comparative Evaluation Italian Study†
Section snippets
Study Design and Participants
This prospective, randomized, controlled, comparative trial involving 57 Italian reference specialist centers and 570 GPs (10 for each specialist center, randomly selected) homogeneously distributed throughout the country was designed to evaluate whether office spirometry by GPs may improve diagnostic accuracy in asthma and COPD. A preliminary phase consisted of two meetings of the 57 specialist centers to agree on the conduct of the study, including materials such as the questionnaires for
Results
The vast majority of GPs attended the educational meetings (95% attended both sessions, and 99% attended at least one). No GP coworkers attended, since most Italian GPs work individually without staff support. Approximately 13% of GPs had postgraduate training in respiratory medicine, but none had ever used a spirometer regularly in their activity as GP.
Eighty-eight percent of GPs had from 1,000 to 1,500 patients registered at their practice; the remaining 12% had < 1,000 patients. Each GP
Discussion
Subjects with chronic respiratory disorders frequently have delayed access to diagnostic evaluation and treatment, in many cases because patients themselves minimize their symptoms and do not consult their GP.4 An ongoing debate in respiratory medicine focuses on whether the performance of spirometry by the GP may help in identifying asthma or COPD patients earlier, offering them a correct treatment even though specialist assessment is not readily available. The aim of our study was to verify
Appendix
The following physicians and Italian Pulmonary Medicine Centers participated in the study: Angelo Adovasio, Ospedale Pieve di Coriano, Pieve di Coriano MN; Vincenzo Albano, Casa di Cura Bernardini, Taranto; Goffredo Alviano, Glaviano, ASL CE/1 - D.S. n.25, Caserta; Saverio Amoroso, Ospedale Civico, Palermo; Antonio Areopagita, Ospedale “Moscati”, Avellino; Giovanni Azzarà, Ambulatorio A.S.L., Reggio Calabria; Guido Basetti, Sani, Ex I.O.T. ASL 10, Firenze; Gianbattista Bottino, Università di
Acknowledgment
We are indebted to OPIS DATA, Milan, Italy (Drs. A. Poli and S. Amigoni) for statistical support.
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Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).
Supported by an unrestricted grant by SIMESA SpA (AstraZeneca Group), Milan, Italy.
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The Spirometry in Asthma and COPD: a Comparative Evaluation (SPACE) study is a project of Associazione Scientifica Interdisciplinare per lo Studio delle Malattie Respiratorie, a scientific association for the multidisciplinary study of respiratory disorders.