Adults treated by a pulmonologist early in their diagnosis for asthma and COPD fare better than those who do not receive that targeted care. The benefits include lower respiratory-related hospitalization and emergency department visit rates than those receiving care from a primary physician.
This comes from the new Canadian study, "Undiagnosed COPD and Asthma Population Study (UCAP)," published in the New England Journal of Medicine. In the trial, researchers from the Ottawa Hospital Research Institute in Ottawa, Ontario, identified adult patients with respiratory symptoms related to asthma or COPD but had not yet been diagnosed. They compared the group to people who had better outcomes when first being treated by a pulmonologist versus a primary care physician.
“Symptomatic persons with previously undiagnosed COPD or asthma who received treatment from a pulmonologist and asthma-COPD educator had less participant-initiated health care utilization for respiratory illness over a one-year period than those who received usual care from their primary care practitioner,” the study’s authors wrote. In addition, they said that “clinical care of persons with undiagnosed asthma or COPD was associated with health benefit, whether care was provided by a specialist or a primary care practitioner.”
The combination, case-finding study and randomized controlled trial was conducted between June 2017 and January 2024 at 17 locations in Canada. The 508 participants ranged in age from 18 years or older and completed a survey about their respiratory symptoms during the previous six months. Those who had a score of at least six on the Asthma Screening Questionnaire or at least 20 on the COPD Diagnostic Questionnaire were recruited to undergo spirometry to determine whether they had undiagnosed asthma or COPD.
Participants who were previously undiagnosed with asthma or COPD were randomly assigned treatment from either a trial pulmonologist and an asthma-COPD educator who provided guideline-based care (but not treatment algorithms) or their own primary care practitioner.
