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GPs' COPD workload set to increase six-fold

By Nigel Praities

Practice workload for COPD patient could increase by six times under a Government strategy asking GPs to case-find people from practice registers.

Government figures – released at the American Thoracic Society in San Diego last weekend – reveal an estimated prevalence of COPD in England greater than experts had predicted, with 9.7% of the population thought to have the disease.

The current recorded prevalence in practice records is around 1.5%, meaning although approximately four million people in the England have COPD only 780,000 have so far been identified.

This compares with research from the East of England Public Health Observatory released last year, that estimated the prevalence of COPD in the general population was 2.8%.

Pulse revealed last year the Government was considering including screening for COPD in its national strategy, which was due to be published in Spring 2009.

The publication of this strategy has been put back to the end of this year, but the Department of Health confirmed they are looking at both opportunistic and proactive case-finding of people with COPD.

A DH spokesperson said: ‘These could include, for example, linking in with existing smoking cessation programmes and/or GPs identifying those with certain pre-disposed risk factors using disease registers.'

Researchers from the University of Birmingham are working on a potential model for case-finding in primary care and they will submit the results to the Department of Health later this year.

Their model – also presented at the ATS meeting – involves targeting all current and ex-smokers patients aged 55 years or older, and they say this picks up 70% of all patients likely to benefit from treatment.

Dr Peymane Adab, senior lecturer in public health at the University of Birmingham, said the technique could be easily done in general practice.

‘By using this simple algorithm we can identify a significant proportion of patients with clinically modifiable disease,' she explained.

Professor David Price, professor of primary care respiratory medicine at the University of Aberdeen and advisor to the COPD strategy implementation group at the DH, said the approach was one of a number of case-finding approaches that could be adopted in primary care.

‘Practices should do whatever they feel comfortable with. If you use a questionnaire that's one way, you can use quick and dirty spirometry to rule it out, or look at people with a certain degree of symptoms,' he said.

Case finding of people with COPD will increase practice workload in dealing with the condition six-fold Case finding of people with COPD will increase practice workload in dealing with the condition six-fold COPD prevalence

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