Spirometry clinical project proves a success

― over 476 spirometry assessments performed at GPHC

Over the last two years, 476 retrospective reviews of spirometry assessments were performed at the Georgetown Public Hospital Corporation (GHPC) where the proportion and trend of these tests met acceptability criteria.
Understanding that optimal management of chronic respiratory diseases relies on accurate diagnosis, the Hospital collaborated with the Vancouver Hospital to embark on a project to access spirometry quality and diagnostic outcomes following the introduction of spirometry into routine clinical practice at the local hospital.
Spirometry (spy-ROM-uh-tree) is a common office test used to assess how well your lungs work by measuring how much air you inhale, how much you exhale and how quickly you exhale.
Spirometry is used to diagnose asthma, chronic obstructive pulmonary disease (COPD) and other conditions that affect breathing. The test may also be used periodically to check whether a treatment for a chronic lung condition is helping you breathe better.
The programme, which began in November 2013, is aimed at developing high-quality spirometry to assist in the diagnosis of airway diseases, such as asthma and COPD, along with other chronic respiratory disorders. Overall, 80.4 per cent of the 454 initial spirometry measurements on unique patients met the acceptability criteria, with no significant change in the proportion of acceptable spirometry over the study period.
The programme started small, with only two registered nurses and one physician employed by the GPHC and with no prior specialised training on respiratory disease. From November 2013 to November 2015, one additional physician and two nurses were trained to meet the demand for services and ensure continuity.
According to the Public Health Ministry, training consisted of five days of on-site spirometry instruction by two Canadian respiratory specialists and two licensed Canadian respiratory therapists.
Ongoing follow-ups were performed remotely, with ongoing remote reviews of all completed spirometry and feedback on both technical aspects of spirometry and interpretation of results. The training team from Canada returned for one week biannually to review the technical details of spirometry and to expand a linked asthma-COPD education and treatment programme.
Chronic Respiratory Disease is a significant and growing source of global morbidity and mortality, and according to the Global Burden of Disease (2013), disability due to chronic respiratory disease has increased by eight per cent since 1990.
COPD is the third most common cause of death and the fifth most common source of disability-adjusted life years (DALYs) globally. Asthma is a less frequent cause of death, but remains a significant source of DALYs and avoidable deaths in the 5–34 years age group.
The Public Health Ministry stated that the GPHC Spirometry Project builds on the early successes and opportunities created by the emerging GPHC/ Public Health Ministry strategic plan targeting non-communicable chronic diseases, including diabetes and heart, kidney and lung diseases.
“Demonstrating that high-quality spirometry is technically feasible is a first step towards broader implementation of respiratory diagnostics, therapy and specialised respiratory education in Guyana,” the Ministry said.