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Öndunarmælingar á heilsugæslustöð : ábendingar, niðurstöður og gæði

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Authors
Gunnar Guðmundsson
Sólveig Dóra Magnúsdóttir
Jón Steinar Jónsson
Issue Date
2004-01-01

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Other Titles
Spirometry in a health care center: indications, results and quality
Citation
Læknablaðið 2004, 90(1):17-19
Abstract
Objective: Spirometry is important for the diagnosis and treatment of lung diseases. Studies on the use of spirometry in health care centers are few and none in Iceland. The objective of this study was to evaluate the use of spirometry in a single health care center in Iceland in regard to indications, quality and results. Materials and methods: Patients evaluated at the Primary Care Clinic in Garethabaer during a 6 month period were included in the study. Information was collected about the spirometry, indications and treatment given. Spirometry was done by a physican or nurse. All spirometries were evaluated by a pulmonary specialist. The study was approved by the National bioethics committee and Data protection agency. Results: During the study period 63 spirometries were done and majority of them were on the request of one physican. There were 19 males and 44 females and the age distribution was from 17 to 69 years of age. Smokers were 17/63, former smokers were 24 and 20 were non smokers. The most common indication for spirometry was cough in 37/63 and dyspnea in 20/63. No spirometry was done for history of smoking only. Twenty eight patients had abnormal lung auscultation. The quality of the spirometry was sufficient in 54/63. In 24/63 patients the spirometry was normal. Of those with abnormal spirometry 30 had obstruction, 3 had restriction and in 6/63 of cases the results were mixed. Conclusion: The study indicates that primary care physicians are underutilizing spirometry for diagnosis of lung diseases.
Tilgangur: Öndunarmælingar (e. spirometry) eru mikilvægt hjálpartæki við greiningu og eftirlit á sjúkdómum í lungum þegar saga og skoðun eru ekki nægjanleg. Rannsóknir á notkun öndunarmælinga í heilsugæslu eru fáar og engar á Íslandi. Tilgangur þessarar rannsóknar var að kanna notkun öndunarmælinga á heilsugæslustöð með tilliti til ábendinga, niðurstaðna og gæða. Efniviður og aðferðir: Þeir sjúklingar sem leituðu á Heilsugæsluna í Garðabæ á sex mánaða tímabili og var boðin öndunarmæling mynduðu rannsóknarhópinn. Allir fengu skriflegar upplýsingar um rannsóknina og gáfu samþykki sitt. Safnað var upplýsingum um öndunarmælinguna, ástæður fyrir henni og veitta meðferð. Mælingarnar voru ýmist gerðar af læknum eða hjúkrunarfræðingum. Allar öndunarmælingar voru skoðaðar og gæði metin af sérfræðingi í lungnasjúkdómum. Niðurstöður: Á rannsóknartímanum voru gerðar 63 öndunarmælingar, þar af voru flestar frá sama lækninum. Um var að ræða 19 karla og 44 konur á aldrinum frá 17 ára til 69 ára. Af þeim reyktu 17/63 einstaklingar, 24 einstaklingar höfðu reykt en voru hættir, 20 einstaklingar höfðu aldrei reykt. Algengasta ábendingin fyrir öndunarmælingu var hósti hjá 37/63 og mæði hjá 20/63 en engin öndunarmæling var gerð vegna reykinga eingöngu. Tuttugu og átta voru með óeðlilega lungnahlustun. Við úrlestur voru 54/63 mælinganna fullnægjandi að gæðum. Eðlilegar voru 24 mælingar en 30 voru með teppu, þrír með herpu en sex með blöndu af teppu og herpu. Ályktun: Notkun öndunarmælinga var ekki almenn meðal lækna heilsugæslustöðvarinnar. Niðurstöðurnar benda til þess að möguleikar heilsugæslulækna til greiningar á lungnasjúkdómum séu vannýttir.
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