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At the heart of general practice since 1960

COPD diagnosis worry

By Nerys Hairon

The scale of misdiagnosis and underdiagnosis of COPD has been highlighted by new research.

More than half of patients with COPD are misdiagnosed with asthma, and a similar proportion of those diagnosed with COPD may not have the disease, the study revealed.

Researchers from Aberdeen and the US used spirometry to assess 600 patients aged over 40 with respiratory problems. They diagnosed 235 with COPD and found 52 per cent had previously been diagnosed with asthma and 11 per cent had no previous diagnosis of obstructive lung disease.

The researchers also found 52 per cent who did have a previous diagnosis of chronic bronchitis or emphysema did not have fixed obstruction on the day of examination, suggesting they may not have COPD.

Professor David Price, joint study leader and professor of primary care respiratory medicine at the University of Aberdeen, said: 'Despite the availability of consensus guideline recommendations, diagnostic confusion between COPD and asthma appears common in the primary care setting.

'The problems are that COPD patients may get inadequate bronchodilation, asthma patients may get inadequate anti-inflammatory therapy and poorer outcome,' he said.

Dr Chris Woodforde, a GP

fellow in respiratory health at Halton PCT in Cheshire, said: 'I think access to spirometry and reliable spirometry is still a big issue.

'A lot of practices do not have quality control measures. I do think you need to have access to good spirometry services.'

Dr Dermot Ryan, a GP with an interest in respiratory medicine in Loughborough, Leicestershire, and a member of the British Thoracic Society, said: 'COPD has only come to our attention over the last four or five years as something we can do something about. It's well recognised it's underdiagnosed and misdiagnosed.'

The study was published in February's Journal of Asthma.

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