Low lung testing rates for Ontarians with COPD
A new study in the medical journal CHEST, led by Sunnybrook Health Sciences Centre researcher and respirologist, Dr. Andrea Gershon, suggests that only one third of people with chronic obstructive pulmonary disease (COPD) in Ontario received recommended testing to confirm their diagnosis.
COPD is a manageable respiratory condition that affects 8 to 22 per cent of adults age 40 and older. It is the third leading cause of death and one of the most common causes of hospitalizations. The diagnosis is made by conducting breathing tests called pulmonary function tests. However, it would seem, most people with COPD never receive these.
Researchers studied all individuals age 35 years and older newly diagnosed with COPD in Ontario between 2000 and 2010 using health administrative databases and found:
- Only 35.9 per cent of the 491,754 Ontarians newly diagnosed with COPD received pulmonary function testing.
- Older and younger people, those living in long-term care and those with stroke and/or dementia were less likely to receive testing
- People who had seen a specialist or had other respiratory disease were more likely to receive testing
- Older primary care physicians were less likely to order testing for their patients.
"We are still not sure why the rates of testing are low," says Dr. Gershon, a scientist at the Institute for Clinical Evaluative Sciences. "Some potential factors could be doubts that some physicians hold about whether these tests really lead to better long term outcomes. It could also be a result of a pre-conceived idea that younger patients are less likely to have COPD or presuming those with stroke or dementia are physically unable to complete testing."
Dr. Gershon, who is also an Assistant Professor with the Departments of Medicine and Health Policy, Management and Evaluation at the University of Toronto, states, "We wanted to call attention to this issue because a lack of testing could lead to people mistakenly being told they have COPD when they do not. It could also lead to true diagnoses being missed and untreated."
The study was supported by the Government of Ontario. The results will be published in the February 2014 issue of CHEST.