COPD Diagnosis with Lung Function Test Linked to Decreased Mortality, Fewer Hospital Admissions

Confirmation of a diagnosis of chronic obstructive pulmonary disease (COPD) using pulmonary function testing is associated with not only a decreased risk of death, but fewer admissions to the hospital due to COPD.

The study reporting the findings, “Outcomes of patients with chronic obstructive pulmonary disease diagnosed with or without pulmonary function testing,” was published in the Canadian Medical Association Journal.

COPD is the third leading global cause of death, a leading cause of hospital admission, and affects more than 10 percent of adults. Pulmonary function testing plays a fundamental role in COPD diagnosis by confirming persistent airflow obstruction and ruling out other diseases.

However, pulmonary function testing is underused, with only about 30 to 50 percent of people with a COPD diagnosis undergoing testing.

“Given low rates of testing, these findings point to an opportunity to improve patient outcomes, reduce health services use and decrease healthcare costs by increasing rates of testing for suspected COPD,” the study’s first author, Dr. Andrea Gershon, from the Sunnybrook Research Institute and the Institute for Clinical Evaluative Sciences (ICES), wrote in the study, according to a news release.

The research team conducted a longitudinal population study of 68,898 patients with physician-diagnosed COPD from 2005 to 2012 using health administrative data from Ontario, Canada. From these, 16,798 patients had recently been diagnosed with the disease.

The researchers assessed whether having pulmonary function testing around the time of diagnosis was associated with the composite outcome of admission to the hospital for COPD or all-cause mortality.

The team found that from the overall patient population, only 41 percent of the patients had received pulmonary function testing. They also found that these patients were more likely to be younger, to have seen a specialist, and to have seen a primary care physician who followed the clinical guideline recommendations for COPD. These patients were also less likely to have other diseases.

Patients who underwent testing were 10 percent less likely to die or be admitted to the hospital for COPD, and were more likely to be prescribed an inhaled long-acting bronchodilator (medications that are used to treat COPD over a longer period of time) than patients who did not undergo testing.

The study results validate current guideline recommendations that encourage pulmonary function testing for diagnosis in all patients with suspected COPD.

“Our results support the commonly held understanding that pulmonary function testing is key to the accurate diagnosis and quality care of people with COPD,” the authors wrote.

The researchers suggest that a more frequent use of pulmonary function testing to diagnose suspected cases of COPD, can help improve patient outcomes, as well as promote a better use of healthcare services and decrease costs.