Introduction. Asthma and chronic obstructive pulmonary disease are often
unrecognized and undertreated. The aim of this study was to describe the
frequency of chronic obstructive pulmonary disease and asthma in primary care
patients in Serbia, and to examine the agreement between general
practitioners and pulmonologists on the diagnosis of chronic obstructive
pulmonary disease and asthma. Material and Methods. In this multicenter
observational study, the general practitioners identified eligible patients
from October 2009 to June 2010. The study included all adult patients with
respiratory symptoms and/or smoking history based on structured interview.
The patients were referred to a pulmonologist and underwent a diagnostic
work-up, including spirometry. Results. There were 2074 patients, 38.4% men,
their mean age being 54?15.5 years. The patients were mostly current (40.3%)
or ex-smokers (27.4%). The common symptoms included shortness of breath
(84.9%), cough (79.1%) and wheezing (64.3%). The diagnosis of chronic
obstructive pulmonary disease was confirmed by pulmonologists in 454 (21.9%)
and asthma in 455 (21.9%) patients. The chronic obstructive pulmonary disease
was newly diagnosed in 226 (10.9%) and asthma in 269 (13%) of the cases.
There was a moderate agreement between the pulmonologists and general
practitioners on the diagnosis of chronic obstructive pulmonary disease
(kappa 0.41, 95%CI 0.36-0.46) and asthma (kappa 0.42, 95% CI 0.37-0.465).
Conclusion. A significant number of patients seen in the general
practitioner?s office were diagnosed with chronic obstructive pulmonary
disease or asthma and half of them represent new cases. A substantial
proportion of patients referred to a pulmonologist by primary care physicians
have been misdiagnosed.
Secondary Polycythemia Vera May Be a Clue for Primary Care Physicians to Start Oxygen Supplementation in Chronic Obstructive Pulmonary Disease
