The concept of pre-COPD: development and feasibility in primary health care

BACKGROUND: Chronic obstructive pulmonary disease is often not diagnosed as a preventable disease. The primary physician needs a diagnostic tool to detect chronic obstructive pulmonary disease at an early stage.

AIM: To develop the concept of early detection of chronic obstructive pulmonary disease through a diagnostic tool that stratifies patients according to the risk of disease development.

MATERIALS AND METHODS: Random sample of persons 35–70 years from the lists provided by 15 polyclinics of Saint Petersburg and Arkhangelsk (cross-sectional study, n = 2388). Cohort prospective study (respondents with fixed or variable obstruction, n = 167). All respondents were asked about demographic data, smoking history, risk factors, and the presence of symptoms. Spirometry with a bronchodilator was performed for all participants.

RESULTS: Fixed obstruction was found in 6.8% of the participants in the first phase; obstruction was associated with male sex, smoking status over 10 packs/years, age over 55 years, chronic cough and shortness of breath. Of the 65 members of the cohort with variable obstruction, 23.1% had a fixed obstruction after a year, the risk factors of which were a smoking status of more than 10 packs/years, a night cough and forced expiratory volume in 1 second less than lower limit of normal.

CONCLUSIONS: Based on the results of the two phases of the study, a diagnostic tool was developed for the early detection of chronic obstructive pulmonary disease in the general population by identifying a group of people with preserved lung function and high-risk chronic obstructive pulmonary disease factors.