Foreword

The importance of spirometry for screening and managing patients with respiratory disease is now well established and there is an increasing call for primary care physicians to include spirometry in their practice. However, the large number of spirometers currently available in Australia makes it difficult for those with little experience to determine which spirometer best suits their practice needs.

The aims of this Spirometer Users' and Buyers’ Guide are to provide

1. a summary of the specifications and features of spirometers on the market to assist purchasers select the most appropriate instrument for their needs, and
2. general information about the measurement and application of spirometry in the primary care clinical setting.

This Guide is not intended to be a comprehensive book on spirometry. A reading list is included for those wishing to obtain more detailed information about spirometry.

Introduction

Spirometry is the most commonly used method for assessing lung function. It is one of the primary tools used worldwide for the diagnosis, assessment and management of many respiratory diseases including asthma and COPD. It is used in conjunction with the patients clinical history to confirm a suspected diagnosis and for ‘fine tuning’ management.

Respiratory disease is a major health problem, and currently:

• About 1 in 5 children and 1 in 8 adults have asthma and there is evidence that the prevalence is increasing.
• In Australia the health costs associated with the care of people with asthma was estimated at about $720 million per year in the 1990s.
• 10 to 20% of older adults have COPD and the prevalence is expected to increase.
• In Australia COPD costs the community more than $800 million per year.
• By 2020, COPD will be the third most common overall cause of death, representing 11% of deaths from any cause.

Despite these disturbing statistics, only approximately 30% of patients having demonstrable airflow obstruction and who are under the care of primary care physician have had their lung function assessed with spirometry.  This means that 70% lack a confirmed diagnosis based on measurement and are not being monitored objectively for optimising interventions. To what extent this impacts on quality of life and disease progression is not well understood.  Spirometry is now well established as a tool for the early detection and management of respiratory conditions and throughout the world physicians are being encouraged to include it in their clinical practice.