Differentiating COPD
from Other Respiratory
Diseases Using Spirometry

Release date: October 1, 2010

Expiration date: December 31, 2011

Credit Available
This activity offers the following types of credit:

• 1.5 Credits Category 1 AMA PRA™
• 1.5 Hours Category 2B, AOA
  
  

Target Audience
This activity is designed for physicians, PAs, NPs and other health care providers who provide care for patients with chronic obstructive pulmonary disease (COPD) and other respiratory conditions.

Activity Format
This interactive activity is based on the latest research and highly advanced understanding of "how" physicians learn and process and organize the vast amount of information needed to differentiate and diagnose similar conditions.

Participants will be presented with unique characteristics of COPD, asthma and similar respiratory conditions and work through cases using spirometry readings to sharpen their skills related to result interpretation and disease diagnosis.

Statement of Need
COPD is one of the most frequent causes of preventable hospitalizations in the country, resulting in substantial economic burden to patients and the community. [1]. Recent data suggest significant reductions in hospitalizations related to COPD can be realized if patients present to an emergency room soon after an exacerbation begins. The same study emphasizes the need for providers to educate patients and caregivers about early recognition and attention to acute COPD exacerbations in order to advance efforts to decrease the morbidity, mortality, and costs of treatment. [2]

COPD is easily diagnosed with the use of spirometry. [3] Regrettably, multiple studies indicate that, in general, half of the cases of COPD are left undiagnosed or misdiagnosed, largely due to poor rates of and quality of testing with spirometry. [4,5,6,7,8] When spirometers are available in primary care offices (and they are only about 30% of the time), they are often underused, even though the test is readily reimbursed by Medicaid and most insurance plans. [4,7,9,10]

Spirometry should be regularly conducted - and correctly interpreted - according to established guidelines to diagnose COPD as early as possible. Only then can effective interventions be initiated and monitored and patients educated on exacerbation prevention and recognition.

References

1. O'Malley A, Pham, H, Schrag, D, Wu, B, Bach, P. Potentially Avoidable Hospitalizations for COPD and Pneumonia: The Role of Physician and Practice Characteristics. Medical Care: June 2007 - Volume 45 - Issue 6 - pp 562-570.
2. Chandra D, Tsai CL, Camargo CA Jr. Acute exacerbations of COPD: delay in presentation and the risk of hospitalization. COPD. 2009 Apr;6(2):95-103.
3. Global Strategy for Diagnosis, Management and Prevention of COPD. Available online at http://www.goldcopd.com. Accessed 23 April 2009.
4. Voelkel NF. Raising awareness of COPD in primary care. Chest. 2000 May;117(5 Suppl 2):372S-5S.
5. White P, Wong W, Fleming T, Gray B. Primary care spirometry: test quality and the feasibility and usefulness of specialist reporting. Br J Gen Pract. 2007 Sep;57(542):701-5.
6. National Heart, Lung, and Blood Institute. Facts About Chronic Obstructive Pulmonary Disease. Available at: http://www.nhlbi.nih.gov/health/public/lung/other/copd_dci.htm. Accessed October 4, 2007.
7. Hueto J, Cebollero P, Pascal I, Cascante JA, Eguía VM, Teruel F, Carpintero M. Spirometry in primary care in Navarre, Spain. Arch Bronconeumol. 2006 Jul;42(7):326-31.
8. Tinkelman DG, Price D, Nordyke RJ, Halbert RJ. COPD screening efforts in primary care: what is the yield? Prim Care Respir J. 2007 Feb;16(1):41-8.
9. Foster JA, Yawn BP, Maziar A, Jenkins T, Rennard SI, Casebeer L. Enhancing COPD management in primary care settings. MedGenMed. 2007;9(3):24.
10. Zanconato S. et al. Office Spirometry in Primary Care Pediatrics: A Pilot Study. Pediatrics. Vol. 116 No. 6 December 2005, pp. e792-e797.
    

Educational Objectives

Those participating in this online activity will receive information and practice skills that should allow them to use spirometry to:

• Rapidly and objectively assess airflow obstruction and restrictive conditions;
• Differentiate between COPD and other respiratory conditions;
• Diagnose earlier and monitor of disease progression of COPD; and
• Quantify the severity of airflow obstruction and disease severity.

Content Development and Disclosures
Content for this interactive activity was developed by:

Sherif Al-Farra, MD, FCCP, DABSM
Associate Professor of Medicine
Chief of Pulmonary and Critical Care Medicine
University of North Texas Health Science Center
Fort Worth, Texas

Dr. Al-Farra has disclosed that he has presented non-CME certified presentations for AstraZeneca within the past 12 months. This activity deals only with the recognition and diagnosis of COPD and other respiratory conditions. Hence, no conflict of interest was identified.

Neither the University of North Texas Health Science Center or its employees involved in activity planning or content development have any relationships with commercial interests to disclose.

Accreditation and Credit

Method of Instruction
To receive continuing education credit, participants must:

• Register for the activity and click "Done" on the final screen"
• Complete the pre-activity cases
• Participate in the activity, advancing through each case.
• Your statement of credit (certificate) will be available for immediate printing.  Additional copies are available by calling 800-987-2263 or visiting http://www.hsc.unt.edu/education/pace/.

A follow-up evaluation will be e-mailed to you approximately two months after completing the activity. Please complete this brief form to help us gauge effectiveness and identify areas for imporvement.

Fee
There is no charge for this activity.

Commercial Support
This activity is commercially supported by an educational grant
from Pfizer Medical Education Group.

Disclaimer
The methods, techniques of clinical practice and practice recommendations are evidence-based and are used by recognized medical authorities for consideration for licensed healthcare professionals to incorporate into practice. Variations of practice, taking into account the needs of the individual patient, available resources, limitations unique to each practice setting, and the clinicians own experience and judgment may be appropriate.

Hardware and Software Requirements

• PC or Mac computer with modern web browser (IE6, Firefox 2 or similar)
• Standard internet connection
• Video Screen Resolution - 1024 x 768 pixels recommended
• A Printer (for printing certificate)
  

Please select the appropriate button below:
If you haven't registered and started the activity... Click the button below to create a profile or log-in to your existing account to register. Be sure to click the "DONE" button on the confirmation page.	If you have already started the activity but haven't finished... Click the button below to pick up where you left off. (the e-mail address you registered with is required).

Privacy Policy