Back to Journals » Journal of Asthma and Allergy » Volume 13

Spirometry Utilization Among Patients with Asthma

Authors Roychowdhury P, Badwal J, Alkhatib F, Singh DK, Lindenauer PK, Knee A, Lagu T

Received 18 March 2020

Accepted for publication 29 May 2020

Published 30 June 2020 Volume 2020:13 Pages 193—203

DOI https://doi.org/10.2147/JAA.S254431

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Luis Garcia-Marcos


Prithwijit Roychowdhury,1 Jasdeep Badwal,2 Fadi Alkhatib,3 Dilpreet Kaur Singh,4 Peter K Lindenauer,5,6 Alexander Knee,5,7 Tara Lagu5,6

1University of Massachusetts Medical School (UMMS), Worcester, MA, USA; 2Allergy and Immunology Associates of New England, Greenfield, MA, USA; 3Larkin Community Hospital, South Miami, FL, USA; 4Arthritis Treatment Center, Springfield, MA, USA; 5Department of Medicine, UMMS-Baystate, Springfield, MA, USA; 6Institute of Healthcare Delivery & Population Science, UMMS-Baystate, Springfield, MA, USA; 7Epidemiology and Biostatistics Research Core, Office of Research, Baystate Medical Center, Springfield, MA, USA

Correspondence: Prithwijit Roychowdhury
University of Massachusetts Medical School (UMMS), Worcester, MA, USA
Email Prithwijit.roychowdhury@umassmed.edu

Objective: To examine predictors of spirometry use at a tertiary academic health system and association between receipt of spirometry and outcomes.
Patients and Methods: We conducted a retrospective cohort study of adult patients with an ICD-9 CM diagnostic code for asthma and a 2014 outpatient visit in either a community health center or private practice associated with a tertiary academic medical center. The main outcome was receipt of spirometry during a 2007– 2015 “exposure period.” We secondarily examined future hospitalizations and emergency department (ED) visits during a follow-up period (2016– 2019).
Results: In a sample of 394 patients, the majority were white (48%; n=188) and female (72%; n=284). Mean (SD) age was 52 years. Approximately half (185, 47%) of the patients received spirometry and 25% (n=97) saw a specialist during the exposure period. Nearly, 88% (n=85) of patients who saw a specialist received spirometry. More than half of the cohort (220/394, 56%) had an ED visit or admission during the follow-up period. Of these, 168 (76.4%) had not seen a specialist and 111 (50.5%) had not received spirometry within the exposure period. We saw no association between spirometry in the exposure window and future ED visit or hospitalization.
Conclusion: In a cohort of patients at a tertiary medical center, spirometry was underused. We observed a strong association between seeing a specialist and use of spirometry, suggesting a need to better incorporate spirometry into routine primary care for patients with asthma. Among 220 patients who had an asthma-related hospitalization or ED visit in 2016– 2019, the majority had no record of receiving spirometry and no documentation indicating a prior specialist visit.

Keywords: asthma, spirometry, health care delivery, quality of care, population health

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php 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]