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Pennequin N, Léger P, Freymond N, Coullandaye N, Poupon D, Tranchard É, Cuoq O, Pacheco Y. [Feasibility and benefits of training to screen for chronic obstructive pulmonary disease]. Rev Mal Respir 2019; 36:861-869. [PMID: 31279593 DOI: 10.1016/j.rmr.2019.05.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 05/09/2019] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Though still under-diagnosed, chronic obstructive pulmonary disease (COPD) currently affects nearly 3.5 million people in France. The present study presents the results of continuing medical education sessions on COPD screening by electronic mini-spirometry. METHODS From April 2013 to December 2015, the sessions involved 73 health professionals. The study analysed three questionnaires administered before, after, and long after sessions led by experts within a professional associative network. RESULTS The sessions proved efficient in increasing the participants' theoretical knowledge. It increased the percentage of correct answers regarding the nature of COPD (90 % vs. 81%), the functions, features, and outputs of mini-spirometers, and the treatment recommendations. The sessions led to non-negligible changes in everyday medical practice regarding the acquisition of a mini-spirometer (+13 devices), the presentation of COPD to the patients (+33 practitioners), the dialogue on tobacco use (+32 practitioners), vaccination (+33 practitioners), and compliance with the treatment recommendations (+43 practitioners). CONCLUSION These results encourage both holding and following up such sessions. The specialized professional environment ensures knowledge updates and offers subsequent assistance. Further improving these sessions will increase their benefits in terms of diagnosis, treatment, and health economy.
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Affiliation(s)
- N Pennequin
- Cabinet de médecine générale, 69100 Villeurbanne, France
| | - P Léger
- Réseau de santé SPIRO, 69003 Lyon, France
| | - N Freymond
- Service de pneumologie, centre hospitalier Lyon Sud, hospices civils de Lyon, 69310 Pierre-Bénite, France
| | | | - D Poupon
- Réseau de santé SPIRO, 69003 Lyon, France
| | - É Tranchard
- Laboratoire d'exploration fonctionnelle respiratoire, centre hospitalier Lyon Sud, hospices civils de Lyon, 69310 Pierre-Bénite, France
| | - O Cuoq
- Cabinet de médecine générale, 69100 Villeurbanne, France
| | - Y Pacheco
- Service de pneumologie, centre hospitalier Lyon Sud, hospices civils de Lyon, 69310 Pierre-Bénite, France.
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Chapron A, Pelé F, Andres É, Fiquet L, Laforest C, Veislinger A, Fougerou C, Turmel V, Fouchard J, Yourish B, Oumari S, Allory E, Banâtre A, Schweyer FX, Pommier J, Brinchault G, Guillot S, Laviolle B, Jouneau S. [Targeted screening of COPD in primary care: Feasibility and effectiveness]. Rev Mal Respir 2019; 36:162-170. [PMID: 30686560 DOI: 10.1016/j.rmr.2018.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 08/14/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) is a common but under-diagnosed pathology in primary care. The objective was to study the feasibility of a randomized controlled trial in general practice to detect new cases of COPD at an earlier stage. METHODS A cluster randomized, controlled, multicenter intervention study comparing, according to a 2×2 factorial plan, two case finding strategies: a systematic GOLD-HAS hetero-questionnaire and coordination of the patient's path to facilitate access to spirometry. The PIL-DISCO pilot study took place in 2017. Patients between 40 and 80 years old, with no previous history of COPD, consulting their GP on a given day regardless of the reason, were included. RESULTS 176 patients were included in 1.5 days. Spirometry was performed in none of the control arm, in 13 (29.5%) of the questionnaire arm, in 22 (50%) in the coordination arm and in 32 (72.7%) with the combination of the two strategies. Two cases of stage 2 COPD and thirteen other respiratory diseases were diagnosed. CONCLUSIONS This study confirms the feasibility of the protocol in primary care in terms of speed of inclusion and acceptability. An extension phase aiming to include 3200 patients will assess the diagnostic value of the two strategies tested in general practice.
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Affiliation(s)
- A Chapron
- Département de médecine générale, université Rennes, 2, avenue du Pr-Léon-Bernard, 35000 Rennes, France; Inserm, CIC 1414, centre d'investigation clinique de Rennes, université Rennes, CHU de Rennes, 35000 Rennes, France; Université Rennes, CNRS, ARENES - UMR 6051, 35000 Rennes, France.
| | - F Pelé
- Département de médecine générale, université Rennes, 2, avenue du Pr-Léon-Bernard, 35000 Rennes, France; Inserm, CIC 1414, centre d'investigation clinique de Rennes, université Rennes, CHU de Rennes, 35000 Rennes, France; Irset, institut de recherche en santé, environnement et travail, université Rennes, UMR_S 1085, 35000 Rennes, France
| | - É Andres
- Département de médecine générale, université Rennes, 2, avenue du Pr-Léon-Bernard, 35000 Rennes, France
| | - L Fiquet
- Département de médecine générale, université Rennes, 2, avenue du Pr-Léon-Bernard, 35000 Rennes, France; Inserm, CIC 1414, centre d'investigation clinique de Rennes, université Rennes, CHU de Rennes, 35000 Rennes, France
| | - C Laforest
- Inserm, CIC 1414, centre d'investigation clinique de Rennes, université Rennes, CHU de Rennes, 35000 Rennes, France
| | - A Veislinger
- Inserm, CIC 1414, centre d'investigation clinique de Rennes, université Rennes, CHU de Rennes, 35000 Rennes, France
| | - C Fougerou
- Inserm, CIC 1414, centre d'investigation clinique de Rennes, université Rennes, CHU de Rennes, 35000 Rennes, France
| | - V Turmel
- Inserm, CIC 1414, centre d'investigation clinique de Rennes, université Rennes, CHU de Rennes, 35000 Rennes, France
| | - J Fouchard
- Inserm, CIC 1414, centre d'investigation clinique de Rennes, université Rennes, CHU de Rennes, 35000 Rennes, France
| | - B Yourish
- Département de médecine générale, université Rennes, 2, avenue du Pr-Léon-Bernard, 35000 Rennes, France
| | - S Oumari
- Département de médecine générale, université Rennes, 2, avenue du Pr-Léon-Bernard, 35000 Rennes, France
| | - E Allory
- Département de médecine générale, université Rennes, 2, avenue du Pr-Léon-Bernard, 35000 Rennes, France; Inserm, CIC 1414, centre d'investigation clinique de Rennes, université Rennes, CHU de Rennes, 35000 Rennes, France
| | - A Banâtre
- Département de médecine générale, université Rennes, 2, avenue du Pr-Léon-Bernard, 35000 Rennes, France; Inserm, CIC 1414, centre d'investigation clinique de Rennes, université Rennes, CHU de Rennes, 35000 Rennes, France
| | - F-X Schweyer
- EHESP, école des hautes études en santé publique, université Rennes, 35000 Rennes, France
| | - J Pommier
- Université Rennes, CNRS, ARENES - UMR 6051, 35000 Rennes, France; EHESP, école des hautes études en santé publique, université Rennes, 35000 Rennes, France
| | - G Brinchault
- Services de pneumologie et explorations fonctionnelles respiratoires, université Rennes, CHU de Rennes, 35000 Rennes, France
| | - S Guillot
- Services de pneumologie et explorations fonctionnelles respiratoires, université Rennes, CHU de Rennes, 35000 Rennes, France
| | - B Laviolle
- Inserm, CIC 1414, centre d'investigation clinique de Rennes, université Rennes, CHU de Rennes, 35000 Rennes, France
| | - S Jouneau
- Irset, institut de recherche en santé, environnement et travail, université Rennes, UMR_S 1085, 35000 Rennes, France; Services de pneumologie et explorations fonctionnelles respiratoires, université Rennes, CHU de Rennes, 35000 Rennes, France
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Roche N, Martin C, Burgel PR. [Personalised COPD care: Where are we going?]. REVUE DE PNEUMOLOGIE CLINIQUE 2018; 74:315-326. [PMID: 30316649 DOI: 10.1016/j.pneumo.2018.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The concept of personalised medicine is recent but the underlying notions are not new: knowing how to adapt care to patients' characteristics is one of the components of the "art of medicine". The advances of science allow to refine considerably the applications of the concept in many fields of medicine including COPD: research has identified phenotypes, endotypes and treatable traits. Personalisation can be applied to all components of care. For instance, the decision to perform screening spirometry relies not only on risk factors (age, smoking, other exposures) but also on symptoms. Assessment of comorbidities often associated with COPD is based on risk factors and their combinations, variable between individuals. Rehabilitation and its components are in essence highly individualised, which a major condition for their success. Last but not least, personalisation of pharmacological therapy, which has long been rather poor, could not benefit from biomarkers of interest (predictive of response), such as blood eosinophil count. Practical strategies using these still need to be established, and new biomarkers may usefully enrich the collection!
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Affiliation(s)
- N Roche
- EA2511, service de pneumologie, université Paris Descartes, hôpital Cochin, hôpitaux universitaires Paris Centre, AP-HP 5, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
| | - C Martin
- EA2511, service de pneumologie, université Paris Descartes, hôpital Cochin, hôpitaux universitaires Paris Centre, AP-HP 5, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | - P-R Burgel
- EA2511, service de pneumologie, université Paris Descartes, hôpital Cochin, hôpitaux universitaires Paris Centre, AP-HP 5, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
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Bunge L, Baruch D, Plantier L, Mazars T, Roche N, Izadifar A. [Study of the feasibility of spirometry in general practice]. Rev Mal Respir 2018; 35:238-248. [PMID: 29605653 DOI: 10.1016/j.rmr.2017.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 05/05/2017] [Indexed: 10/17/2022]
Abstract
COPD is common but is under-diagnosed by general practitioners (GP). GP have a major role in the early diagnosis of this disease. GP could have access to spirometry. The aim of this study was to evaluate the quality and interpretation of spirometry performed by primary care residents following a short education session. Three residents were trained in spirometry for half a day. They then performed spirometry on all smokers over the age of 35 visiting five general practices. The results were reviewed blindly by an independent specialist pulmonologist to assess their quality and interpretation. Among 184 eligible patients, 89% agreed to participate and 66% (n=107) came for the second appointment. The pulmonologist evaluated the quality of spirometry as good in 72% of cases, of suboptimal but acceptable quality in 20% and of poor quality in 8%. Interpretation was accurate in 91% of tests. The Kappa concordance coefficient between GPs and the expert was 0.93. Airflow obstruction was detected in 17.5% of the screened subjects. The average time for a consultation with spirometry was 19minutes. The consultation dedicated to spirometry was well accepted by patients. A short training has to be structured to allow GPs to perform and interpret spirometry properly. This work needs to be extended to better assess reproducibility in cases of abnormal spirometry.
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Affiliation(s)
- L Bunge
- Clinique universitaire de médecine générale, université Paris-Diderot, 5, rue Thomas-Mann, 75013 Paris, France.
| | - D Baruch
- Médecine générale, université Paris-Diderot, 75013 Paris, France
| | - L Plantier
- Service des explorations fonctionnelles, hôpital Bichat (75), 75018 Paris, France
| | - T Mazars
- Médecine générale, université Paris-Diderot, 75013 Paris, France
| | - N Roche
- Service de pneumologie, hôpital Cochin (75), 75014 Paris, France
| | - A Izadifar
- Centre cardiologique du Nord, 93200 Saint-Denis, France
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Roche N, Ajjouri R, Compagnon A, Van Der Molen T, Mullerova H. [French data from the Continuing to Confront COPD (C2C) survey]. Rev Mal Respir 2016; 34:180-187. [PMID: 27423810 DOI: 10.1016/j.rmr.2016.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 04/04/2016] [Indexed: 11/16/2022]
Abstract
INTRODUCTION This article describes the French data which contributed to the international "Continuing to Confront COPD" (C2C) survey conducted in 2013 across 12 countries. Its objective was to describe the characteristics, symptoms and impact of COPD on health status, daily activities and working life in adults identified with the study definition as COPD; i.e., reporting a diagnosis of COPD, emphysema, chronic bronchitis (CB) or symptoms of CB either currently present or for which they had been treated in the past. METHODS Subjects 40 years or older were screened using random-digit-dialing and those fulfilling the study COPD definition were invited to complete the full survey. RESULTS The proportion of respondents with COPD (according to study definition) in France was estimated at 7.5%. Among 300 respondents with COPD and complete questionnaire data, 48% were male, 44% aged over 70years, 45% were overweight and 72% had a smoking history. COPD had a severe or very severe impact (COPD assessment test score>20) on health for 43%. Dyspnea (mMRC ≥ 1) was reported by 70% and a limitation of at least 20% of daily activities by 65%. The mean number of exacerbations was 2/year and 16% had been admitted to hospital for respiratory problems during the past year. However, using direct questions, 80% subjects considered that they had mild to moderately severe disease and 78% reported an acceptable health status. CONCLUSION The impact of COPD is markedly underestimated by respondents with COPD despite a high level of symptoms, poor health status and frequent exacerbations as assessed with validated measures.
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Affiliation(s)
- N Roche
- Service de pneumologie et réanimation, AP-HP groupe hospitalier Hôtel-Dieu et université Paris Descartes, 74, boulevard de Port-Royal, 75004 Paris, France.
| | - R Ajjouri
- GlaxoSmithKline, 100, route de Versailles, 78160 Marly-le-Roi, France
| | - A Compagnon
- GlaxoSmithKline, 100, route de Versailles, 78160 Marly-le-Roi, France
| | - T Van Der Molen
- Centre médical de l'université de Groningen, université de Groningen, Groningen, Pays-Bas
| | - H Mullerova
- GlaxoSmithKline Research & Development, Respiratory Epidemiology, Uxbridge, Royaume-Uni
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Giraud V, Beauchet A, Gomis T, Chinet T. Feasibility of spirometry in primary care to screen for COPD: a pilot study. Int J Chron Obstruct Pulmon Dis 2016; 11:335-40. [PMID: 26929617 PMCID: PMC4760207 DOI: 10.2147/copd.s96385] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background COPD is a frequent but underdiagnosed disease whose diagnosis relies on the spirometric demonstration of bronchial obstruction. Spirometry use by general practitioners could represent the first line in COPD diagnosis. Objective Because duration of spirometry is retarding its development in primary care, we decided to measure the time it requires in the primary-care context in France. Methods Ten volunteer general practitioners were trained during two 3-hour theoretical and practical continuing education sessions. Then, from October 2013 to May 2014, they included patients without any known respiratory disease but at risk of developing COPD (age: ≥40 years, smoker: ≥20 pack-years). The duration of spirometry and its quality were evaluated according to the following acceptability criteria: 1) expiration ≥6 seconds or reaching a plateau; 2) good start with an early peak flow, curve peaked on top and not flat; 3) no artifacts; and 4) reproducibility criteria, ie, forced expiratory volume in 1 second and forced vital capacity differences between the two best spirometry curves ≤0.15 L. Quality of the spirograms was defined as optimal when all the criteria were met and acceptable when all the criteria were satisfied except the reproducibility criterion, otherwise, it was unacceptable. Results For the 152 patients included, the 142 assessable spirometries lasted for 15.2±5.9 minutes. Acceptability criteria 1–3, respectively, were satisfied for 90.1%, 89.4%, and 91.5% of patients and reproducibility criterion 4 for 56.3%. Quality was considered optimal for 58.5% of the curves and acceptable for 30.2%. Conclusion The duration of spirometry renders it poorly compatible with the current primary-care practice in France other than for dedicated consultations. Moreover, the quality of spirometry needs to be improved.
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Affiliation(s)
- Violaine Giraud
- AP-HP, Department of Pneumology and Thoracic Oncology, Ambroise-Paré Hospital, Paris, France; UEFR Paris île-de-France Ouest, Versailles Saint Quentin-en-Yvelines University, Paris, France
| | - Alain Beauchet
- Public Health Department, Unité de Recherche Clinique, Hôpitaux Universitaires Paris Ile-de-France Ouest, Paris, France
| | | | - Thierry Chinet
- AP-HP, Department of Pneumology and Thoracic Oncology, Ambroise-Paré Hospital, Paris, France; UEFR Paris île-de-France Ouest, Versailles Saint Quentin-en-Yvelines University, Paris, France
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Is generalization of exhaled CO assessment in primary care helpful for early diagnosis of COPD? BMC Pulm Med 2015; 15:44. [PMID: 25927404 PMCID: PMC4434881 DOI: 10.1186/s12890-015-0039-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 04/15/2015] [Indexed: 11/25/2022] Open
Abstract
Background COPD is largely under-diagnosed and once diagnosed usually at a late stage. Early diagnosis is thoroughly recommended but most attempts failed as the disease is marginally known and screening marginally accepted. It is a rare cause of concern in primary care and spirometry is not very common. Exhaled carbon monoxide (eCO) is a 5-seconds easy-to-use device dedicated to monitor cigarette smoke consumption. We aimed to assess whether systematic eCO measurement in primary care is a useful tool to improve acceptance for early COPD diagnosis. Methods This was a two-center randomized controlled trial enrolling 410 patients between March and May, 2013. Whatever was the reason of attendance to the clinic, all adults were proposed to measure eCO during randomly chosen days and outcomes were compared between the two different groups of patients (performing and not performing eCO). Primary outcome was the rates of acceptance for COPD screening. Results Rate of acceptance for COPD screening was 28% in the eCO group and 26% in the other (P = 0.575). These rates increased to 48 and 51% in smokers (current and former). eCO significantly increased the rate of clinics during which a debate on smoking was initiated (42 vs. 24%, P = 0.001). eCO at 2.5 ppm was the discriminative concentration for identifying active smokers (ROC curve AUC: 0.935). Smoking was the only independent risk factor associated with acceptance for early COPD screening (OR = 364.6 (82.5-901.5) and OR = 78.5 (18.7-330.0) in current and former smokers, respectively) while eCO measurement was not. Conclusions Early COPD diagnosis is a minor cause of concern in primary care. Systematic eCO assessment failed to improve acceptance for early COPD screening.
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Roche N, Humbert M. [Current issues to improve care for COPD]. Presse Med 2014; 43:1334-6. [PMID: 25455632 DOI: 10.1016/j.lpm.2014.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 09/09/2014] [Indexed: 11/30/2022] Open
Affiliation(s)
- Nicolas Roche
- AP-HP, hôpital Cochin, service de pneumologie, 75014 Paris, France; Université Paris-Descartes (EA2511), Sorbonne Paris Cité, 75014 Paris, France.
| | - Marc Humbert
- Université Paris-Sud, 94270 Le Kremlin-Bicêtre, France; AP-HP, hôpital Bicêtre, centre de référence de l'hypertension pulmonaire sévère, service de pneumologie, DHU Thorax Innovation, 94270 Le Kremlin-Bicêtre, France; Inserm UMR_S 999, LabEx LERMIT, centre chirurgical Marie-Lannelongue, 92350 Le Plessis-Robinson, France
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Degano B, Soumagne T. [Clinical and functional assessment in COPD: from case finding to follow-up]. Presse Med 2014; 43:1344-52. [PMID: 25455633 DOI: 10.1016/j.lpm.2014.05.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 05/09/2014] [Accepted: 05/20/2014] [Indexed: 11/17/2022] Open
Abstract
A spirometry with bronchodilator test is needed for the diagnosis of COPD. It is recommended to detect COPD only in subjects with symptoms (dyspnoea and/or chronic cough and/or chronic sputum production) and a history of exposure to risk factors for the disease (tobacco smoking and/or occupational exposure). Measurement of peak expiratory flow to detect COPD, although simpler than conventional spirometry, allows only detection of the most severe cases of COPD. Specialist referral is often useful in the diagnosis of COPD, to establish the presence of incompletely reversible airflow obstruction, assess severity (using clinical questionnaires, plethysmography, exercise testing and arterial blood gases when indicated) and define future management. The level of FEV1 is associated with individualized assessment of symptoms and evaluation of exacerbation risk in the management strategy of stable COPD.
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Affiliation(s)
- Bruno Degano
- CHU de Besançon, hôpital Jean-Minjoz, physiologie-explorations fonctionnelles, EA 3920, 25030 Besançon cedex, France.
| | - Thibaud Soumagne
- CHU de Besançon, hôpital Jean-Minjoz, physiologie-explorations fonctionnelles, EA 3920, 25030 Besançon cedex, France; CHU de Besançon, hôpital Jean-Minjoz, pneumologie, 25030 Besançon cedex, France
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Épidémiologie et dépistage de la BPCO en France. Workshop de la Société de pneumologie de langue française (SPLF). Rev Mal Respir 2014; 31:693-9. [DOI: 10.1016/j.rmr.2014.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 04/25/2014] [Indexed: 11/17/2022]
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Lemoigne F, Barré E, Arsento M, Bily F, Gibelin G, Pelser M, Paillasseur JL, Garcia-Macé J, Perez T, Roche N. [Early detection of COPD in occupational medicine in the Alpes-Maritimes]. Rev Mal Respir 2014; 32:30-7. [PMID: 25618202 DOI: 10.1016/j.rmr.2014.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Accepted: 01/06/2014] [Indexed: 11/16/2022]
Abstract
INTRODUCTION This study evaluated a standardized procedure aiming at early detection of COPD in a consecutive population of employees visiting occupational medicine. METHODS A total of 2818 employees were included by 22 occupational physicians in 5 centers. Respiratory symptoms, smoking status, occupational exposures and socioprofessional categories were collected. Subjects with at least one symptom and/or risk factor underwent spirometry. RESULTS In this population aged 39±12 years, 2603 patients were free of known asthma or COPD. The presence of at least one symptom was observed in 23.6 % of employees and was significantly associated with smoking status, occupational exposure to organic dust, gas fumes and vapors, and agriculture (P<0.0001). Airflow obstruction (FEV1/FVC < 0.70) was detected in 1.7 % of 1605 employees who underwent spirometry. With the inclusion of known COPD subjects (n=22), the prevalence reached 2.38 %. COPD was significantly associated with smoking intensity. Information on subsequent diagnosis was obtained in only two cases. The quality of spirometry was inadequate in 30 % of cases. Thirty-three percent of detected COPD subjects did not report any respiratory symptoms. CONCLUSION The strategy used in this study (specific questionnaire plus spirometry) allowed detection of a few cases of previously undiagnosed COPD. Occupational physicians need specific training in spirometry and a better follow-up of care pathways is required to obtain diagnostic confirmation.
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Affiliation(s)
- F Lemoigne
- Service de pneumologie, hôpital Pasteur, 30, voie Romaine, BP 69, 06002 Nice cedex, France.
| | - E Barré
- AMETRA 06, service de santé au travail des Alpes-Maritimes, 06560 Sophia Antipolis, France
| | - M Arsento
- Association du service médical de l'aromatique (ASMAROM), 06130 Grasse, France
| | - F Bily
- Centre de gestion de la fonction publique territoriale (CG-FT), 06704 Saint-Laurent-du-Var, France
| | - G Gibelin
- Mutualité sociale agricole (MSA), 06200 Nice, France
| | - M Pelser
- Association paritaire de santé au travail BTP 06 (APST BTP 06), 06000 Nice, France
| | | | - J Garcia-Macé
- JGM Health Conseils, 95240 Cormeilles-en-Parisis, France
| | - T Perez
- Pneumologie, CHRU de Lille, 59000 Lille, France
| | - N Roche
- Service de pneumologie et des soins intensifs respiratoires, hôpital Cochin, site Val-de-Grâce, AP-HP, université Paris Descartes, 75679 Paris, France
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Vorilhon P, Deat J, Gérard A, Laine E, Laporte C, Ruivard M, Vaillant Roussel H. Dépistage de la broncho-pneumopathie chronique obstructive par minispirométrie électronique en médecine générale. Rev Mal Respir 2014; 31:396-403. [DOI: 10.1016/j.rmr.2013.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2012] [Accepted: 07/08/2013] [Indexed: 11/24/2022]
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Chambellan A, Housset B. Dépistage et diagnostic précoce de la BPCO en médecine générale. Rev Mal Respir 2014; 31:391-3. [DOI: 10.1016/j.rmr.2014.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Accepted: 01/06/2014] [Indexed: 10/25/2022]
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Perez T, Bizon C. La mini-spirométrie : un outil pertinent de dépistage de la BPCO en médecine générale ? Rev Mal Respir 2012; 29:853-5. [DOI: 10.1016/j.rmr.2012.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 07/13/2012] [Indexed: 11/29/2022]
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