Powerpoint template for scientific posters Swarthmore College

1
SPIRO project COPD patients can live longer and
with better quality
Jana Bendová, Iveta VaverkováGeneral
practitioners, Slovakia

• Introduction
• Boom of COPD requires an improved approach. GPs
  should play the crucial role in COPD diagnostics
  by performing spirometry in their practices.
• This project emphasizes the necessity of
  spirometry in primary care.
• Primary aim is
• to slowdown the progressive worsening of lung
  function via early diagnosis and good management
  of our COPD patients thus improving the quality
  of their lives as well as prognosis.
• Secondary aims
• to screen all smokers in our
• care aged 35 and over
• to increase the number of
• patients who quit smoking
• to reduce the acute
• exacerbation rate

• Design and methods
• This pilot project started in two general
  practices in Slovakia in January 2009. Patients
  aged 35 years and over with a history of chronic
  smoking (more than
• 5 years and more than 10 cigarettes a day) are
  included.
• At the baseline
• medical history taken using
• Clinical COPD questionnaire
• physical examination
• spirometry
• bronchodilatation test, if
• obstruction detected
• severity assessed
• appropriate treatment started
• or pneumologist referral
• Visits follow at least once a year, including
  spirometry. As a part of the project help with
  smoking cessation is offered at baseline as well
  as at each visit.
• Easy to use hand-held spirometers with real time
  graphical display and

Results ECSC
(European Community for Steal and Coal) reference
values used The small number of newly diagnosed
airways obstruction indicates, that the screening
spirometry based only on age and pack-years is
NOT EFFECTIVE. It seems to be more effective to
perform spirometry on patients who achieved
higher clinical COPD questionnaire score.

• Conclusions
• It is quite difficult to implement spirometry
  into our daily practice.
• Major barriers are
• financial
• PC based spirometers are expensive for Slovak
  GPs
• spirometry is not reimbursed
• organizational
• trained personnel not available
• spirometry is time-demanding (seeing 40-50
  patients a day
• there is no space for proper spirometry, i.e.
  3 acceptable blows)
• patients not trained to blow optimally (active
  cooperation is
• necessary in comparison to blood pressure
  measurement where passive
• participation is enough)
• Spirometry is not easy to perform and to
  interpret,
• still there is no simpler test available.

SLOVAKIA
in the heart of Europe The situation in
Slovakia in 2008 Population 5.4 million
only a few GPs possess any spirometer COPD
prevalence 8 14 of no
training in spirometry or smoking
population aged over 40
cessation available for GPs One GP takes care of
1600 1800 spirometry not reimbursed
at all adult patients in average
treatment options very limited due
to i.e. each GP has got in his care
prescription restrictions 90 180
COPD patients GPs allowed
to prescribe salbutamol,

ipratropium and theophyllin only ! How many of
them are diagnosed? pneumologist
referral necessary for

appropriate treatment POSTER No. 398

For further information Please contact Jana
Bendová JanaB13_at_gmail.com or
Iveta Vaverková i.vaverkov_at_gmail.com Slovak
Society for General Practice of Slovak Medical
Association www.vpl.sk