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Central Surgery,
King Street, Barton on Humber, North Lincolnshire DN18 5ER, UK
Correspondence to: Dr J A Dickinson.
Received 1 June 1998; Returned to authors 27 July 1998; Revised version received 26 January 1999; Accepted for publication 29 January 1999
BACKGROUND
Obstructive
airways disease in older patients is reported to be not only common,
but frequently overlooked and untreated by general practitioners. This
study examines the value of screening elderly patients in a large
semi-rural general practice for potentially treatable asthma and
chronic obstructive pulmonary disease (COPD).
METHODSA random
sample of 353 patients aged 60-75 years attended a nurse run screening
clinic for pulmonary function testing, serial peak flow recording, and
completion of a symptom questionnaire. Patients with a low forced
expiratory volume in one second (below the fifth centile of their
predicted value) or >15% mean diurnal variation in peak flow were
referred to a doctor's clinic for further
diagnostic assessment and/or to discuss possible treatment where appropriate.
RESULTSFifty eight
patients (16.4%) had obstructive airways disease, the prevalence of
asthma being 6.5% and that of COPD 9.9%. Of these, 30 had no previous
diagnosis of airways disease and were not on treatment; eight of them
had significant airways reversibility and 10 were current smokers. No
newly diagnosed patients had severe disease as measured by pulmonary
function or quality of life assessment, and six patients accepted treatment.
CONCLUSIONFew older
patients benefited from a screening programme for obstructive airways
disease in a semi-rural general practice.
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