Early detection of COPD in general practice: patient or practice managed? A randomised controlled trial of two strategies in different socioeconomic environments

Joseph A. M. Dirven*, Huibert J. Tange, Jean W. M. Muris, Karin M. A. van Haaren, Gerrit Vink, Onno C. P. van Schayck

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background: The burden of chronic obstructive pulmonary disease (COPD) is high. Health benefits can be gained in primary care by early detection and preventive measures. Aims: To compare the effectiveness of two strategies for population-based early detection of COPD, taking into account different socioeconomic status (SES) settings. Methods: Practices were randomised on strategy and stratified on SES setting. The Respiratory Health Screening Questionnaire (RHSQ) was distributed to all participants. In the practice-managed condition, the practice was responsible for the whole procedure, while in the patient-managed condition, patients were responsible for calculating their RHSQ risk score and applying for a spirometry test. The main outcome measure was the rate of COPD diagnoses after screening. Results: More new COPD patients were detected in the practice-managed condition (36%) than in the patient-managed condition (18%). In low SES practices, more high-risk patients were found (16%) than in moderate-to-high SES practices (9%). Recalculated for a standard Dutch practice (2,350 patients), the yield would be 8.9 new COPD diagnoses, which is a 20% increase of known cases. Conclusions: The practice-managed variant of this screening procedure shows a substantial yield of new COPD diagnoses for both low and moderate-to-high SES practices.
Original languageEnglish
Pages (from-to)331-337
JournalPrimary Care Respiratory Journal
Issue number3
Publication statusPublished - Sept 2013


  • COPD
  • screening
  • questionnaire
  • spirometry
  • socioeconomic status
  • randomised controlled trial

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