Screening increases COPD, heart failure diagnoses

the Clinical Advisor take:

Targeting screening strategies can identify previously undiagnosed heart failure and chronic obstructive pulmonary disease (COPD) in the elderly, according to a study published in the Journal of the American Board of Family Medicine.

Lead researcher Yvonne van Mourik, MD, of the University Medical Center Utrecht, Stratenum in Utrecht, the Netherlands, and colleagues found that 43.9% of patients in their study who underwent screening had previously undiagnosed heart failure or COPD.

The study included 570 community-dwelling, frail people aged ≥65 years. Each participant received a questionnaire that asked about dyspnea and exercise intolerance. Participants with dyspnea and/or exercise intolerance were invited to visit their primary care physician for a screening program that included medical history taking, physical examination, blood tests, electrocardiography, spirometry, and echocardiography. A panel of three physicians then determined a final diagnosis.

Out of the total participants, 395 had reduced exercise tolerance or dyspnea, and 389 opted for the screening program. Out of those who were screened, 33.5% received a new diagnosis of heart failure, and 16.8% received a new diagnosis of COPD. Other patients received new diagnoses of atrial fibrillation (1.8%), valvular disease (21.4%), asthma (3.1%), anemia (12.7%), and thyroid disease (0.6%).

The researchers noted that further studies will need to determine whether optimizing treatment of the newly-detected diagnoses will improve quality of life and reduce morbidity and mortality in this population.

Screening increases COPD, heart failure diagnoses
Screening increases COPD, heart failure diagnoses

Background: Reduced exercise tolerance and dyspnea are common in older people, and heart failure (HF) and chronic obstructive pulmonary disease (COPD) are the main causes. We want to determine the prevalence of previously unrecognized HF, COPD, and other chronic diseases in frail older people using a near-home targeted screening strategy.

Conclusion: Unrecognized chronic diseases might be detected in community-dwelling frail elderly using a near-home screening strategy that is simple to implement. It remains to be proven, however, whether optimizing treatment of the newly detected diagnoses in this fragile population with multimorbidities and polypharmacy improves quality of life and reduces morbidity and mortality.

READ FULL ARTICLE From Journal of the ABFM
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