Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 6

Asthma, chronic obstructive pulmonary disease, or both? Diagnostic labeling and spirometry in primary care patients aged 40 years or more

Authors Melbye H, Drivenes, Dalbak, Leinan, Hoegh-Henrichsen, Ostrem

Published 17 November 2011 Volume 2011:6 Pages 597—603


Review by Single-blind

Peer reviewer comments 2

Hasse Melbye1, Elin Drivenes1, Lene G Dalbak2, Tone Leinan1, Svein Høegh-Henrichsen2, Anders Østrem2
1General Practice Research Unit, Department of Community Medicine, University of Tromsø, 2General Practice Research Unit, Department of Health and Society, University of Oslo, Norway

Aims: To describe symptoms and lung function in patients registered with asthma or chronic obstructive pulmonary disease (COPD) in primary care and to examine how spirometry findings fit with general practitioners’ (GPs) diagnoses.
Methods: Patients aged ≥40 years with a diagnosis of asthma or COPD registered in the electronic medical record during the previous 5 years were recruited at seven GP offices in Norway in 2009–2010. Registered diagnosis, spirometry results, comorbidity, and reported symptoms were compared.
Results: Among 376 patients, 62% were women. Based on Global Initiative for Chronic Obstructive Lung Diseases criteria, a spirometry diagnosis of COPD could be made in 68.1% of the patients with a previous COPD diagnosis and in 17.1% of those diagnosed with asthma only (P < 0.001). The κ agreement between last clinical diagnosis of COPD and COPD based on spirometry was 0.50. A restrictive spirometry pattern was found in 19.4% and more frequently in patients diagnosed with both asthma and COPD (23.9%) than in patients diagnosed with COPD only (6.8%, P = 0.003).
Conclusion: The ability of GPs to differentiate between asthma and COPD seems to have considerably improved during the last decade, probably due to the dissemination of spirometry and guidelines for COPD diagnosis. A diagnosis of COPD that cannot be confirmed by spirometry represents a challenge in clinical practice, in particular when a restrictive pattern on spirometry is found.

Keywords: asthma, COPD, diagnosis, primary care

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]


Other articles by this author:

Readers of this article also read:

Nanolayer formation on titanium by phosphonated gelatin for cell adhesion and growth enhancement

Zhou X, Park SH, Mao H, Isoshima T, Wang Y, Ito Y

International Journal of Nanomedicine 2015, 10:5597-5607

Published Date: 2 September 2015

Screening of COPD patients for abdominal aortic aneurysm

Flessenkaemper IH, Loddenkemper R, Roll S, Enke-Melzer K, Wurps H, Bauer TT

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:1085-1091

Published Date: 10 June 2015

Conjugation of cell-penetrating peptides with poly(lactic-co-glycolic acid)-polyethylene glycol nanoparticles improves ocular drug delivery

Vasconcelos A, Vega E, Pérez Y, Gómara MJ, García ML, Haro I

International Journal of Nanomedicine 2015, 10:609-631

Published Date: 27 January 2015

Association of genetic polymorphisms with chronic obstructive pulmonary disease in the Hainan population: a case-control study

Ding YP, Yang DL, Xun XJ, Wang ZF, Sun P, Xu DC, He P, Niu H, Jin TB

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:7-13

Published Date: 17 December 2014

Biomechanical evaluation and surface characterization of a nano-modified surface on PEEK implants: a study in the rabbit tibia

Johansson P, Jimbo R, Kjellin P, Currie F, Chrcanovic BR, Wennerberg A

International Journal of Nanomedicine 2014, 9:3903-3911

Published Date: 14 August 2014

P-wave indices in patients with pulmonary emphysema: do P-terminal force and interatrial block have confounding effects?

Chhabra L, Chaubey VK, Kothagundla C, Bajaj R, Kaul S, Spodick DH

International Journal of Chronic Obstructive Pulmonary Disease 2013, 8:245-250

Published Date: 14 May 2013

Hypoxemia in patients with COPD: cause, effects, and disease progression

Brian D Kent, Patrick D Mitchell, Walter T McNicholas

International Journal of Chronic Obstructive Pulmonary Disease 2011, 6:199-208

Published Date: 14 March 2011