Belgian General Practitioners’ perspectives on the use of spirometry in primary care: a qualitative study

Introduction: Many patients with chronic respiratory disease remain undetected in Belgium, leading to increased healthcare costs. Standard use of spirometry in primary care, could help identify more patients with chronic lung disease. However, such practice is not well integrated into the Belgian health care system. Objectives: The goal of this study is to gain insights in the prevailing ideas of Belgian general practitioners (GPs) about the role of spirometry in primary care, as well as to identify limiting and facilitating factors for implementation in primary care. As this qualitative study was part of a larger project on the use of spirometry supported by AI-guided software, we specifically aimed to learn how GPs wanted to be supported in the performance and interpretation of spirometry results. Methods: Semi-structured interviews were conducted with 8 GPs in 3 different GP practices. The interviews were video- and audio recorded, transcribed verbatim and analyzed using NVivo 1.7.1. Results: In general, GPs recognize the need for more objective findings before making a diagnosis or changing therapy in chronic respiratory disease. They find spirometry to be a valuable asset in primary care. Both unfamiliarity with the procedure (insufficient training and confidence in use) and practical organization (limited time per patient, required material, encouraging patients’ participation) were considered barriers. The use of AI-based software is perceived as a diagnostic support but does not help overcome the issues at an organizational level. Conclusion: Introducing routine use of spirometry, especially when supported by AI-guided interpretation, might be an asset to the primary care management of chronic lung disease but several practical issues at the organizational level limit immediate implementation.