Characterisation of existing COPD diagnoses in the Health Centre Group of Braga (Portugal)

Introduction: Portuguese and international guidelines state that, for a COPD diagnosis to be made, symptoms and risk factors must be present, and irreversible obstruction must be shown by spirometry. In 2018, Portuguese national data showed that only 37.3% of COPD diagnosis registered in primary health care units had a spirometry done. The purpose of this project was to characterise all the existing COPD diagnoses in the Braga region, concerning the presence of risk factors and spirometry. Methods: This was an observational, descriptive and analytical study. It was approved by local and regional ethics committee. All COPD patients enrolled in the participant units were included. Data were collected from the respective clinical files, during 2019 and 2020. The analysis was made concerning the diagnosis certainty, considering risk factors and spirometry results. Results: A total of 1817 patients were included, from 74 family physicians, mean prevalence 2.72% (± 1.17). Mean age at diagnosis 63.51 years (± 12.09) and at the data collection moment 68.46 (± 12.09); 64.2% male. Only 5.9% had a spirometry result totally compatible with the COPD diagnosis; 48.8% had a dubious result; 45.3% had a result not compatible with the diagnosis. A clear risk factor history was registered in 44.9%; 45.8% didn’t have any know risk factor. Only 3.63% had a spirometry and clear risk factor exposition compatible with COPD. Being male, more recent diagnoses and having registered risk factors were more frequently associated with a more correct diagnosis. Discussion: The results show important flaws in the process of diagnosing COPD, but it is only shown what was registered in the patients’ files. This is a limitation, as diagnoses may had been correctly performed, but were not properly registered. Future studies should be focused on what should be done to correct this situation.