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Perisse A, Dao MC, Butty D, Derkenne C, Charton F, Fabre N, Grosset-Janin A, Lutringer M, Chanet A, Diop E, Attia C, Coudert A, Courson A, Maillot G, Augen AS, Bagary P, Sahuguet E, Remond O, Paleiron N, Bylicki O. Long-Term Consequences of Spirometry During Military Routine Medical Examinations on Smoking Cessation Compared to Minimal Advice. Mil Med 2023:usad473. [PMID: 38109715 DOI: 10.1093/milmed/usad473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/21/2023] [Accepted: 12/02/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Smoking kills 8 million people a year worldwide. It is the most prevalent cause of death in France by cancer, cardiovascular, or respiratory diseases. Minimal advice consists in asking patients who smoke if they are interested in quitting. It is effective in reducing smoking. The French High Health Authority recommends its systematic use with patients, whatever their reason for seeking treatment. The beneficial effect of spirometry on smoking cessation is controversial. The objective of our study was to measure the consequences of spirometry associated with minimal advice, compared with only minimal advice in soldiers seen during a routine medical examination. METHODS Our prospective, longitudinal, open, multicenter, controlled, randomized study was conducted among French military smokers presenting for an occupational medicine visit. Each participant received, depending on their group (intervention or control), either minimal advice associated with an evaluation of lung function by mini-spirometer, or only minimal advice. Follow-up visits were performed at 6 and 12 months. The primary objective was self-reported tobacco use cessation at 6 months. RESULTS A total of 267 participants (126 in the intervention group and 141 for the control arm) were included in 10 centers between June 2019 and June 2020. The response rate was 75.6% at 6 months. The cessation rates were 17% and 18% in the intervention and control groups, respectively, with no significant difference between the two groups (P = 0.9). The cessation rate in the general population was 13% at 6 months. CONCLUSIONS Spirometry does not seem to influence smoke cessation on a military population at 6 months. The overall cessation rate in our study was well in excess of the 3-6% expected from only providing minimal which is underused in general practice and should be encouraged.
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Affiliation(s)
- Anne Perisse
- 9th Military Medical Center, Service de Santé des Armées, Toulon Cedex 9 83800, France
| | - Marie-Cécile Dao
- 13th Military Medical Center, Service de Santé des Armées, Rochefort Air 17133, France
| | - Damien Butty
- 3rd Military Medical Center, Service de Santé des Armées, Lille Cedex 59001, France
| | | | - France Charton
- 1st Military medical center, Service de Santé des Armées, PARIS Cedex 12 75614, France
| | - Nathalie Fabre
- 1st Military medical center, Service de Santé des Armées, PARIS Cedex 12 75614, France
| | - Anais Grosset-Janin
- 1st Military medical center, Service de Santé des Armées, PARIS Cedex 12 75614, France
| | - Manon Lutringer
- 1st Military medical center, Service de Santé des Armées, PARIS Cedex 12 75614, France
| | - Aurore Chanet
- 1st Military medical center, Service de Santé des Armées, PARIS Cedex 12 75614, France
| | - Elie Diop
- 1st Military medical center, Service de Santé des Armées, PARIS Cedex 12 75614, France
| | - Claire Attia
- 1st Military medical center, Service de Santé des Armées, PARIS Cedex 12 75614, France
| | - Anne Coudert
- 1st Military medical center, Service de Santé des Armées, PARIS Cedex 12 75614, France
| | - Audrey Courson
- 9th Military Medical Center, Service de Santé des Armées, Toulon Cedex 9 83800, France
| | - Gaelle Maillot
- 9th Military Medical Center, Service de Santé des Armées, Toulon Cedex 9 83800, France
| | - Anne-Sophie Augen
- 9th Military Medical Center, Service de Santé des Armées, Toulon Cedex 9 83800, France
| | - Pierre Bagary
- 1st Military medical center, Service de Santé des Armées, PARIS Cedex 12 75614, France
| | - Emilie Sahuguet
- 1st Military medical center, Service de Santé des Armées, PARIS Cedex 12 75614, France
| | - Odile Remond
- 1st Military medical center, Service de Santé des Armées, PARIS Cedex 12 75614, France
| | - Nicolas Paleiron
- Department of Pneumology, Military hospital Sainte-Anne, Toulon 83800, France
| | - Olivier Bylicki
- Department of Pneumology, Military hospital Sainte-Anne, Toulon 83800, France
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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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