[Spirometry as method of screening and intervention in high- risk smokers in primary care]. / Espirometría como método de cribado y de intervención antitabaco en fumadores de alto riesgo en atención primaria.

ABSTRACT

OBJECTIVE: To show the effectiveness of screening in the detection of new cases of COPD in smokers of high-risk, and to describe the characteristics associated with COPD, as well as determine the predisposition to quit. DESIGN: A cross-sectional and multicentre study. LOCATION Basic Primary Care Centres representing different rural and urban areas of Lleida. PARTICIPANTS: A total of 497 active smokers without COPD from 40 to 70 years selected from the database Primary Care Database (e-CAP). INTERVENTION Spirometry was performed on all patients. The spirometry results were reported and brief counselling was given on quitting smoking and the readiness to stop smoking was determined. VARIABLES Age, gender, height, weight, smoking, respiratory symptoms and physical activity. RESULTS: The majority of patients (65.4%) were men, age 51± 7.6 years. They smoked an average of 32 packs/year; 40.4% performed moderate activity and 27.4% referred to some respiratory symptoms. Of the 25% who had an obstructive or mixed pattern, 75.8% of the cases had a moderate level of severity. A decision to quit was made by 38.8%. In the multivariate analysis, gender, age 50 to 59 years and a smoking index>40 were associated with COPD. Moderate or intense physical activity decreased the risk of COPD. CONCLUSIONS: To perform spirometry in high-risk smokers, to show the spirometry results and give brief anti-smoking counselling, enables not previously diagnosed cases of COPD to be detected. It also helps to determine the readiness to stop smoking and to establish individualised treatment and follow-up plans.