Yau Chean Kooi, Rahim Fairuz Fadzilah, Sheng Chin Jiunn, Ling Choi Xin, Weng Liew Kah, Chia Tan Chia, Chye Tan Kean, Ting Ooi Siew, Jin Tan Hong, Ali Irfhan Ali Hyder
Department of Family Medicine, Penang Medical College, 4, Jalan Sepoy Lines, 10450 Pulau Pinang, Malaysia.
Department of Public Health, Penang Medical College, 4, Jalan Sepoy Lines, 10450 Pulau Pinang, Malaysia.
Malays J Med Sci. 2018 May;25(3):78-87. doi: 10.21315/mjms2018.25.3.8. Epub 2018 Jun 28.
Many smokers have undiagnosed chronic obstructive pulmonary disease (COPD), and yet screening for COPD is not recommended. Smokers who know that they have airflow limitation are more likely to quit smoking. This study aims to identify the prevalence and predictors of airflow limitation among smokers in primary care.
Current smokers ≥ 40 years old who were asymptomatic clinic attendees in a primary care setting were recruited consecutively for two months. We used a two-step strategy. Step 1: participants filled in a questionnaire. Step 2: Assessment of airflow limitation using a pocket spirometer. Multiple logistic regression was utilised to determine the best risk predictors for airflow limitation.
Three hundred participants were recruited. Mean age was 58.35 (SD 10.30) years old and mean smoking history was 34.56 pack-years (SD 25.23). One in two smokers were found to have airflow limitation; the predictors were Indian ethnicity, prolonged smoking pack-year history and Lung Function Questionnaire score ≤ 18. Readiness to quit smoking and the awareness of COPD were low.
The high prevalence of airflow limitation and low readiness to quit smoking imply urgency with helping smokers to quit smoking. Identifying airflow limitation as an additional motivator for smoking cessation intervention may be considered. A two-step case-finding method is potentially feasible.
许多吸烟者患有未被诊断出的慢性阻塞性肺疾病（COPD），然而目前并不推荐对COPD进行筛查。知晓自己存在气流受限的吸烟者更有可能戒烟。本研究旨在确定初级保健机构中吸烟者气流受限的患病率及预测因素。
连续两个月招募年龄≥40岁、在初级保健机构无症状就诊的现吸烟者。我们采用两步法策略。第一步：参与者填写一份问卷。第二步：使用便携式肺量计评估气流受限情况。采用多元逻辑回归确定气流受限的最佳风险预测因素。
共招募了300名参与者。平均年龄为58.35（标准差10.30）岁，平均吸烟史为34.56包年（标准差25.23）。发现每两名吸烟者中就有一人存在气流受限；预测因素为印度族裔、吸烟包年史较长以及肺功能问卷得分≤18。戒烟意愿和对COPD的知晓率较低。
气流受限的高患病率和较低的戒烟意愿意味着帮助吸烟者戒烟具有紧迫性。可考虑将识别气流受限作为戒烟干预的额外激励因素。两步法病例发现方法可能可行。
