Kotaki Kenji, Ikeda Hisao, Fukuda Takeshi, Yuki Fumiko, Hasuo Kanehiro, Kawano Yuhei, Kawasaki Masayuki
Department of Physical Therapy, Faculty of Fukuoka Medical Technology, Teikyo University, Fukuoka, Japan.
BMJ Open. 2017 Jan 12;7(1):e012923. doi: 10.1136/bmjopen-2016-012923.
This study aimed to evaluate the effectiveness of a cooperative healthcare model for early detection and diagnosis of chronic obstructive pulmonary disease (COPD).
This was a cross-sectional observational study. We performed diagnosis of COPD at 4 public health centres in Ōmuta, Japan from March 2015 to March 2016, by adding screening for COPD at the time of routine medical evaluations. All patients aged over 40 years were eligible to participate. Among 397 eligible patients, 293 agreed to participate in the study.
The estimated prevalence of COPD in Ōmuta was 10% among patients aged over 40 years and was 17% among smokers. Among those who were screened, over half of them had questionnaire scores over the cut-off of 17 points and decreased FEV1/FVC%, indicating COPD (p>0.05). 30 patients with suspected COPD were referred for further investigation at a local central hospital, but only 6 underwent further medical examinations.
The combination of a COPD questionnaire and medical examination is effective as a COPD screening tool. Future research should investigate behavioural interventions for smoking cessation that can be offered in a cooperative model, as well as for improving participation in COPD screening and for encouraging early presentation for treatment in those suspected of having COPD.
本研究旨在评估一种合作医疗模式在慢性阻塞性肺疾病（COPD）早期检测和诊断中的有效性。
这是一项横断面观察性研究。2015年3月至2016年3月期间，我们在日本大牟田市的4个公共卫生中心，通过在常规医疗评估时增加COPD筛查来进行COPD诊断。所有40岁以上的患者均有资格参与。在397名符合条件的患者中，293人同意参与研究。
大牟田市40岁以上患者中COPD的估计患病率为10%，吸烟者中为17%。在接受筛查的患者中，超过一半的问卷得分超过17分的临界值且FEV1/FVC%降低，提示患有COPD（p>0.05）。30名疑似COPD的患者被转诊至当地中心医院进行进一步检查，但只有6人接受了进一步的医学检查。
COPD问卷和医学检查相结合作为COPD筛查工具是有效的。未来的研究应调查可在合作模式中提供的戒烟行为干预措施，以及提高COPD筛查的参与度和鼓励疑似COPD患者尽早就诊治疗。
