NEW study results have highlighted the effect of early diagnosis and treatment of undiagnosed chronic obstructive pulmonary disease (COPD) or asthma. The study led by Shawn Aaron et al., explored the effects on individuals with COPD or asthma who experience respiratory symptoms but remain undiagnosed and untreated. The results of this study were presented at ATS 2024 International Conference.
A multi-center population-based case-finding study was coupled to a randomized, controlled trial. Adults with respiratory symptoms who had no previous diagnosis of lung disease were recruited from 17 Canadian communities using random digit-dialing. Participants underwent spirometry tests before and after bronchodilator use to diagnose COPD or asthma. Those diagnosed were then randomized into two groups: one receiving guideline-based treatment from a pulmonologist and an asthma/COPD educator, and the other receiving usual care from their primary-care practitioners.
Out of 26,905 individuals screened, 4,272 were eligible for spirometry, and 2,857 completed the tests. Of these, 595 (21%) were found to have undiagnosed COPD or asthma. Among them, 508 (85%) agreed to participate in the trial, with 253 assigned to the intervention group and 255 to usual care.
The compelling results revealed that patients in the intervention group had significantly fewer healthcare utilization events for respiratory illness, with 0.51 events per patient per year compared to 1.09 events in the usual care group (IRR=0.47, 95% CI: 0.36-0.62). Quality of life also improved more in the intervention group, with a -10.2 point improvement in the St. George’s Respiratory Questionnaire (SGRQ) compared to -6.8 points in the usual care group, showing a -3.5 point difference in favor of the intervention (P=0.009). Symptom scores and lung function also showed greater improvements in the intervention group.
This study underscores the critical need to adopt early diagnostic strategies and guideline-based treatment for asthma and COPD, and the findings demonstrate that proactive management can lead to significant reductions in healthcare utilization and improvements in quality of life and lung function.
Reference
Aaron et al. Early Detection and Treatment of Undiagnosed Asthma and COPD: A Randomized Controlled Trial. B14. American Thoracic Society Annual Meeting 2024.
