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Improving spirometry testing by understanding patient preferences

Barbara Johnson, Irene Steenbruggen, Brian L. Graham, Courtney Coleman
ERJ Open Research 2021 7: 00712-2020; DOI: 10.1183/23120541.00712-2020
Barbara Johnson
1European Lung Foundation, Sheffield, UK
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Irene Steenbruggen
2Lung Function Dept, Isala Hospital, Zwolle, The Netherlands
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Brian L. Graham
3Respiratory Research Centre, Division of Respirology, Critical Care and Sleep Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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Courtney Coleman
1European Lung Foundation, Sheffield, UK
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Tables

  • TABLE 1

    Reasons for initial spirometry referral

    Investigating a problem with your breathing/to get a diagnosis625 (35.0)
    Chronic obstructive pulmonary disease301 (16.9)
    Asthma296 (16.6)
    Cystic fibrosis165 (9.2)
    Pulmonary fibrosis (for interstitial lung disease)117 (6.6)
    Bronchiectasis86 (4.8)
    Idiopathic pulmonary fibrosis76 (4.3)
    Occupational health testing65 (3.6)
    Pre-operative testing as part of your work-up for surgery24 (1.3)
    Lung cancer18 (1.0)
    Neuromuscular disease13 (0.7)

    Data are presented as n (%). Respondents could select more than one option (total responses n=1786).

    • TABLE 2

      Respondents rating potential issues about spirometry testing as moderately or severely problematic

      To keep blowing even though you do not feel anything is coming out31.4
      Coughing30.4
      Feeling tired after the test26.3
      Concerns about shortness of breath due to the test20.1
      Concerns about ability to complete the test17.5
      Feeling dizzy17.5
      Nose clip uncomfortable16.6
      Dryness in mouth13.2
      Not given enough information about why the test is done12.1
      Mouthpiece uncomfortable12.0
      Not given enough information about how to perform the test11.7
      Requirement to withhold inhalers prior to the test11.4
      Lack of support from healthcare professionals running the test9.8
      Feel embarrassed during the test (e.g. being shouted at to blow)9.7

      Data are presented as %.

      • TABLE 3

        Tips for healthcare providers when conducting spirometry tests

        Provide clear advice to patients in advance of the test, including the reasons for carrying the test out and whether they need to discontinue using medication and inhalers
        Ensure that tests are carried out in a quiet, private space and prepare the room in advance, e.g. by providing sputum pots, tissues and water
        Give clear verbal instructions to patients before and during the procedure, even if the patient is experienced in taking spirometry tests
        Between manoeuvres in a testing session, always ask the patient if they are ready to proceed before continuing the series
        Allow time for a practice test and avoid rushing patients who are anxious or having difficulty taking the test
        Give encouragement to patients during the test but avoid shouting instructions
        Allow patients sufficient time to recover after the test
        Inform the patient of their lung volume values, if permitted by local protocols; if appropriate, provide a comparison with their previous results or predicted values
        Healthcare professionals who interpret spirometry are encouraged to explain results to their patients and provide comparisons to normal values
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      Vol 7 Issue 1 Table of Contents
      ERJ Open Research: 7 (1)
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      Improving spirometry testing by understanding patient preferences
      Barbara Johnson, Irene Steenbruggen, Brian L. Graham, Courtney Coleman
      ERJ Open Research Jan 2021, 7 (1) 00712-2020; DOI: 10.1183/23120541.00712-2020

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      Improving spirometry testing by understanding patient preferences
      Barbara Johnson, Irene Steenbruggen, Brian L. Graham, Courtney Coleman
      ERJ Open Research Jan 2021, 7 (1) 00712-2020; DOI: 10.1183/23120541.00712-2020
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