医学
哮喘
肺活量测定
慢性阻塞性肺病
社会心理的
儿科
急诊科
人口
生活质量(医疗保健)
支气管扩张剂
物理疗法
内科学
精神科
护理部
环境卫生
作者
Mathew Cherian,K Magner,G. À. Whitmore,Katherine L. Vandemheen,J. Mark FitzGerald,C. Bergeron,Louis‐Philippe Boulet,Andréanne Côté,Stephen K. Field,Erika Penz,R. Andrew McIvor,Catherine Lemière,Samir Gupta,Irvin Mayers,Mohit Bhutani,Paul Hernández,M. Diane Lougheed,Christopher Licskai,Tanweer Azher,Martha Ainslie,Nicole Ezer,Sunita Mulpuru,Shawn D. Aaron
出处
期刊:The European respiratory journal
[European Respiratory Society]
日期:2022-11-03
卷期号:61 (2): 2201721-2201721
被引量:2
标识
DOI:10.1183/13993003.01721-2022
摘要
Background It remains unclear why some symptomatic individuals with asthma or COPD remain undiagnosed. Here, we compare patient and physician characteristics between symptomatic individuals with obstructive lung disease (OLD) who are undiagnosed and individuals with physician-diagnosed OLD. Methods Using random-digit dialling and population-based case finding, we recruited 451 participants with symptomatic undiagnosed OLD and 205 symptomatic control participants with physician-diagnosed OLD. Data on symptoms, quality of life and healthcare utilisation were analysed. We surveyed family physicians of participants in both groups to elucidate differences in physician practices that could contribute to undiagnosed OLD. Results Participants with undiagnosed OLD had lower mean pre-bronchodilator forced expiratory volume in 1 s percentage predicted compared with those who were diagnosed (75.2% versus 80.8%; OR 0.975, 95% CI 0.963–0.987). They reported greater psychosocial impacts due to symptoms and worse energy and fatigue than those with diagnosed OLD. Undiagnosed OLD was more common in participants whose family physicians were practising for >15 years and in those whose physicians reported that they were likely to prescribe respiratory medications without doing spirometry. Undiagnosed OLD was more common among participants who had never undergone spirometry (OR 10.83, 95% CI 6.18–18.98) or who were never referred to a specialist (OR 5.92, 95% CI 3.58–9.77). Undiagnosed OLD was less common among participants who had required emergency department care (OR 0.44, 95% CI 0.20–0.97). Conclusions Individuals with symptomatic undiagnosed OLD have worse pre-bronchodilator lung function and present with greater psychosocial impacts on quality of life compared with their diagnosed counterparts. They were less likely to have received appropriate investigations and specialist referral for their respiratory symptoms.
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