Do Not Diagnose or Routinely Treat Asthma or COPD Without Pulmonary Function Testing

Asthma and chronic obstructive pulmonary disease (COPD) are among the most common chronic diseases seen in primary care, affecting 262 million and 212 million individuals worldwide. Unfortunately, many patients receive treatment for suspected asthma or COPD without formal lung function testing known as spirometry. These clinical diagnoses can be incorrect, exposing patients to the possible harms of unnecessary therapies while also missing the true diagnoses.

What are the barriers to lung function testing?

Barriers to use of pulmonary function testing for asthma and COPD diagnosis are dependent on context, given that access to spirometry varies both across and within countries. In primary care settings, where most patients receive diagnosis and management, some providers offer in-office spirometry, whereas others refer patients to a pulmonary function laboratory.

How should practice change? 

Authors of this article suggest targeted improvement strategies such education programs, electronic decision support, and audit and feedback, may improve lung function testing for suspected asthma or COPD. However, solutions must target provider, patient, and system-level barriers that may restrict spirometry testing.