Why early diagnosis is so important

Manish Chatterjee is a COPD Case Manager and Respiratory Specialist Physiotherapist who has been working in this field for 13 years. We asked him about the importance of early diagnosis and how spirometry testing can help diagnose COPD. 

How did you become interested in respiratory physio?

When I was doing my junior rotations in medicine and intensive care, I developed an interest in respiratory physiology, the role of medications in the care of people with lung disease, and pulmonary rehabilitation – tailored exercise classes for people with lung disease. Lung disease is extremely prominent in the UK, but it seemed like it was often overlooked – perhaps because of the stigma around smoking. It was during this time I decided I wanted to gain expertise and extend my scope of practice as a physiotherapist in respiratory medicine.

Why is early diagnosis so important for lung disease?

Damage to the lungs cannot be reversed, so it’s important to catch it early. Delayed diagnosis results in delayed treatment and smoking-cessation intervention, so early and accurate diagnosis is a window of opportunity to make a real difference to a patient’s life. There’s also lots of evidence out there to suggest millions of people across the UK have COPD and don’t know – often wrongly thinking you gradually become breathless as you grow older, or they just have a ‘smoker’s cough’. It’s a sad reality that people with COPD often struggle with day-to-day activities because of their symptoms, and have a lower quality of life, so the sooner they start treatment, the better. 

Why is it that some patients are misdiagnosed?

Diagnosing COPD can be challenging as the signs and symptoms closely mimic those of asthma. Besides this, the other main issue is lack of quality-assured spirometry in primary care. Correct diagnosis is extremely crucial, as misdiagnosis leads to inappropriate treatment and poor health outcomes.

How can spirometry testing help to diagnose COPD?

Spirometry is a fairly easy and practical test that can be done in a clinic or even patient’s home. It measures lung function and the results are displayed on a graph. Spirometry can help detect COPD, especially in smokers, even if symptoms are not noticeable or significant. Diagnosing COPD in early stages can encourage the patient to quit smoking and gives us an opportunity to commence the person on treatments that are most effective and will work better compared to later or more severe stages.

What would you say to health care professionals who might not see the value in spirometry testing?

We all know the burden of COPD on health economy. Spirometry is a safe and cost-effective procedure – it’s a test the majority of patients are able to perform, and if done by a trained operator, the results are reliable. Importantly, it can and should be used in primary care to improve early detection and diagnosis of COPD. COPD is a progressive disease and if we simply rely on presence of symptom, then we lose the window of opportunity to prevent the disease worsening. 

Why is it important for the Taskforce for Lung Health to campaign for more awareness of lung disease and better treatment and care for patients?

As it stands, we know many patients wait too long to be diagnosed with lung disease. There’s also the issue of incorrect diagnosis, which means people don’t get the right care at the right time. This has a significant impact on secondary care such as in hospital, where patients often end up. There is clearly a need to raise more awareness to promote the concept of right care at the right time, so patients with suspected lung disease will get the right diagnosis, treatment and support they need. That’s why I support the Taskforce for Lung Health.

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5 April 2019