Guideline-Based Early Detection of Chronic Obstructive Pulmonary Disease in Eight Danish Municipalities: The TOP-KOM Study

Abstract EN

Background.

Early detection of chronic obstructive pulmonary disease (COPD) and prevention of disease progression are important.

Only 40% of COPD cases are diagnosed in Denmark.

Recommendations for early case finding have been established.

This study investigates early detection of pulmonary obstruction in a Danish municipality setting.

Methods.

Eight municipalities participated.

Citizens fulfilling national case finding recommendations, age ≥35 years, smokers/ex-smokers/relevant occupational exposure, and at least one respiratory symptom, were invited to spirometry.

Citizens with indication of pulmonary obstruction, forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) < 0.70, were referred to their general practitioner (GP).

Results.

1,499 citizens were examined (53.6% male, mean age 57.2 years).

44.8% were current smokers with 57% planning for smoking cessation.

The citizens recorded significant airway symptoms with dyspnea being the most important (71%).

The mean FEV1/FVC score was 73.54 (SD 22.84).

456 citizens (30.4%) were found to have indication for pulmonary obstruction and were referred to GP for further diagnosis.

Conclusion.

Early detection in Danish municipalities proved effective finding nearly 1/3 being pulmonary obstructive.

It seems to be of value to have municipalities to perform case finding together with smoking cessation as a primary intervention in COPD management.