A NEW qualitative study conducted in France highlights the multiple obstacles patients face before receiving a chronic obstructive pulmonary disease (COPD) diagnosis, despite the condition being both common and treatable. Researchers identified 12 key barriers that slow the diagnostic process, spanning from early symptom onset to specialist consultation.
Interviews with 15 patients and 15 physicians, including eight pulmonologists and seven general practitioners (GPs), revealed three critical phases in the diagnostic journey. The first phase, before seeking medical care, includes four major obstacles: lack of awareness about COPD, denial of symptoms, fear of lung cancer, and delays in scheduling GP visits. Many patients mistake their symptoms for temporary issues rather than a chronic condition, which prevents early intervention.
The second phase, occurring at the primary care level, presents three additional barriers: patients and physicians often normalise chronic bronchitis, doctors prioritise other diseases with overlapping symptoms, and there is limited access to COPD screening tools. Time constraints in primary care settings and a focus on curative treatments rather than early detection further delay referrals to specialists.
The third and most challenging phase involves specialised medicine, where five more barriers emerge: physicians often begin treatment before confirming a diagnosis, referrals to pulmonologists occur too late, patients struggle to access specialists and testing facilities, some are reluctant to undergo further examinations, and diagnostic confirmation frequently requires additional tests.
The authors highlight the shared responsibility among patients, primary care providers, pulmonologists, and health authorities in addressing these diagnostic delays. Raising awareness and improving early screening strategies could enhance COPD detection rates and allow for more timely interventions.
Ada Enesco, EMJ
Reference
Roucoux G et al; ABCD Study Group. Twelve barriers to COPD diagnosis in France: a comparative qualitative study. BMJ Open Respir Res. 2025;12(1):e002708.
