The following is a summary of “How Important is Spirometry for Identifying Patients with COPD Appropriate for Palliative Care?,” published in the March 2023 issue of Pain and Symptom Management by Lange, et al.

Providing palliative care to patients suffering from a chronic obstructive pulmonary disease (COPD) is considered important. A diagnostic test for COPD is spirometry, which measures airflow limitation and is a common criterion for inclusion in palliative care research. However, the requirement for spirometry may exclude appropriate patients who cannot complete the test or those with preserved-ratio impaired spirometry and symptoms or imaging consistent with COPD.

In the study, patients with COPD who were enrolled in a palliative care trial were included. These patients were identified as at high risk of hospitalization and death and reported poor quality of life. The study measured several aspects of their health, including their quality of life (using the Functional Assessment of Cancer Therapy–General (FACT-G), the Clinical COPD Questionnaire, and Quality of Life at the End of Life) and their symptoms (using the Patient Health Questionnaire-8, Generalized Anxiety Disorder-7, fatigue, and Insomnia Severity Index). These measures were used to compare differences in quality of life and symptoms between patients identified based on International Classification of Diseases (ICD) codes and spirometry with airflow limitation versus patients identified using ICD codes alone.

208 patients who had COPD participated in the study, and they were mainly male and white, with an average age of 68.4 years. The study found no significant differences in quality of life, as measured by the FACT-G, and other symptoms between patients identified through International Classification of Diseases codes and spirometry with airflow limitation versus those identified based on ICD codes alone. The mean FACT-G score was 59.0 for patients with spirometry compared to 55.0 for those without spirometry, but this difference was not statistically significant (P = 0.33).

The findings suggested that spirometry may not be necessary for inclusion in palliative care research or clinical care for patients with poor quality of life and at high risk for adverse outcomes.

Reference: jpsmjournal.com/article/S0885-3924(22)00976-9/fulltext