Impact of a 5-hour workshop on the interpretation of spirometry
Vázquez-García, Juan Carlos , Ortiz-Siordia, Rebeca , Franco-Marina, Francisco , Salas-Hernández, Jorge , Benítez-Pérez, Rosaura Esperanza , Pérez-Padilla, Rogelio
2019, Number 3
2019; 78 (3)
ABSTRACT
Introduction: Underdiagnosis and misdiagnosis of asthma and COPD is enormous worldwide. This is partly explained by a poor accessibility and medical use of spirometry. The aim of this study was to describe the impact of a 5-hour workshop on medical competence regarding use and interpretation of spirometry. Method: Topic sessions, a technical video and 16-real spirometries workshop were developed for the project. Medical professionals from 31 states completed a residential course with initial and final evaluation. Results: A total of 1,343 professionals, 71.3% general practitioners and family physicians, completed the workshop and examination. Only 37% were able to recognized post-bronchodilator spirometry as the recommended diagnostic test for COPD and 11% correctly diagnosed severe airflow obstruction in the baseline evaluation. After the workshop, there was a significant improvement in all items of the examination and 81.2 % correctly recognized severe airflow obstruction. Conclusion: In this study medical knowledge and competence for using and interpreting spirometry in general practice is clearly insufficient, but a few-hours workshop may be highly efficient for training medical competence in continuous medical education programs.
KEYWORDS
Spirometry, asthma, COPD, primary health care, medical education.
REFERENCES
Instituto Nacional de Estadística Geografía e Informática. Registros de mortalidad. [Consultado: 27 de julio de 2017]. Disponible en: http://www.inegi.org.mx/est/contenidos/proyectos/registros/vitales/mortalidad/tabulados/ConsultaMortalidad.asp.
Menezes AM, Perez-Padilla R, Jardim JR, et al.; PLATINO Team. Chronic obstructive pulmonary disease in five Latin American cities (the PLATINO study): A prevalence study. Lancet 2005;366(9500):1875-1881.
Regalado J, Pérez Padilla JR. Epidemiología del asma. En: Salas Hernández J, Chapela Mendoza R, Vargas MH, editores. Asma y condiciones especiales. México: PyDESA; 2015.p.1-25.
Lamprecht B, Soriano JB, Studnicka M, et al.; BOLD Collaborative Research Group, the EPI-SCAN Team, the PLATINO Team, and the PREPOCOL Study Group. Determinants of underdiagnosis of COPD in national and international surveys. Chest 2015;148(4):971-985. doi: 10.1378/chest.14-2535.
Pérez-Padilla R. Would widespread availability of spirometry solve the problem of underdiagnosis of COPD?. Int J Tuberc Lung Dis 2016;20(1):4. doi: 10.5588/ijtld.15.0893.
Perez-Padilla R, Torre Bouscoulet L, Vázquez García JC. Implementing a spirometry program. Int J Tuberc Lung Dis 2016;20(9):1142. doi: 10.5588/ijtld.16.0512.
Guía Mexicana de Asma. Neumol Cir Torax 2017;76(suppl 1):s1-s136.
Global Strategy for Asthma Management and Prevention, Global Initiative for Asthma (GINA) 2017 Update. [Consultado: 28 de junio de 2017]. Disponible en: http://ginasthma.org/.
Global Initiative for Chronic Obstructive Lung Disease (GOLD) Global strategy for the diagnosis, management and prevention of COPD, GOLD 2017. [Consultado: 28 de junio de 2017]. Disponible en: http://goldcopd.org/gold-2017-global-strategy-diagnosis-management-prevention-copd/.
Miller MR, Hankinson J, Brusasco V, et al. Standardization of spirometry. Eur Respir J 2005;26(2):319-338.
Pellegrino R, Viegi G, Brusasco V, et al. Interpretative strategies for lung function tests. Eur Respir J 2005;26(5):948-968.
Ferguson GT, Enright PL, Buist AS, Higgins MW. Office spirometry for lung health assessment in adults: a consensus statement from the National Lung Health Education Program. Respir Care 2000;45(5):513-530.
Levy ML, Quanjer PH, Booker R, Cooper BG, Holmes S, Small IR.; General Practice Airways Group. Diagnostic spirometry in primary care: Proposed standards for general practice compliant with American Thoracic Society and European Respiratory Society recommendations. Prim Care Respir J 2009; 18(3):130-147. doi: 10.4104/pcrj.2009.00054.
Coates A L, Graham BL, McFadden RG, et al. Spirometry in primary care. Can Respir J 2013;20(1):13-21.
Pérez PJR, Vázquez GJC. Manual de entrenamiento en espirometría. México: Asociación Latinoamericana del Tórax (ALAT); 2006.
Vázquez GJC, Pérez PJR. Manual para el uso y la interpretación de la espirometría por el Médico. México: Asociación Latinoamericana del Tórax (ALAT); 2007.
Pagano M, Gauvreau K. Principles of biostatistics. CA: Duxbury; 2000.
Hutchinson J. On the capacity of the lungs, and on the respiratory functions, with a view of stablishing a precise and easy method of detecting disease by the spirometer. Med Chir Trans 1846;29:137-252.
Anthonisen NR, Connett, JE, Kiley JP, et al. Effects of smoking intervention and the use of an inhaled anticholinergic bronchodilator on the rate of decline of FEV1. The Lung Health Study. JAMA 1994;272(19):1497-1505.
Mannino DM, Gagnon RC, Petty TL, Lydick E. Obstructive lung disease and low lung function in adults in the United States: data from the National Health and Nutrition Examination Survey, 1988-1994. Arch Intern Med 2000;160:1683-1689.
Petty TL, Weinmann GG. Building a national strategy for the prevention and management of and research in chronic obstructive pulmonary disease. National Heart, Lung, and Blood Institute Workshop Summary. JAMA 1997;277(3):246-253.
Secretaría de Salud. Prevención y control de las enfermedades respiratorias e influenza. Programa Sectorial de Salud 2013-2018. México: SSA; 2014.
Ledesma AM. Análisis de la Teoría de Vigotsky para la reconstrucción de la inteligencia social. Cuenca, Ecuador: Universidad Católica de Cuenca; 2014. p.104.
Arancibia V, Herrera P, Strasser K. Psicología de la educación. 2ª ed. México, D.F.: Alfaomega, Universidad Católica de Chile; 1999. p. 280.