Spirometry Key to Addressing the Challenge of COPD Under-diagnosis in the Country

TIL Desk Lucknow/ World COPD (Chronic Obstructive Pulmonary Disease) Day is observed in November, to raise awareness about this chronic lung condition which is the 2 nd leading cause of death and accounts for approximately 9.5% of the total deaths in India 1. An umbrella term for a group of chronic inflammatory lung disorders, COPD is characterized by obstructed airflow and damage to the lungs. The onset of COPD is gradual, leading to patients failing to recognise their condition and not seeking timely medical intervention. Early diagnosis of COPD has proven to be critical in addressing the COPD burden and can result in significantly improved outcomes.

COPD is usually caused by long-term exposure to noxious particles or gases like cigarette smoke, chulha smoke, and air pollutants, to name a few. Patients experience symptoms like shortness of breath, cough, sputum production, wheezing, and a feeling of tightness in the chest. In such patients, a lung function test called spirometry needs to be done to confirm a COPD diagnosis. Spirometry is the gold-standard diagnostic test for COPD 2 and involves measurement of the amount of air one can breathe in and out, depicting the lung function of an individual. However, spirometry is highly underutilized, especially among primary or first point of care physicians for patients at the early stages of the disease 2 .

This is largely due to limited access to spirometers and limited innovation in this area. Highlighting the importance of a spirometry test, Dr. B. P. Singh, Respiratory, Critical Care & Specialist for Sleep Medicine, Lucknow said, “Chronic Obstructive Pulmonary Disease (COPD) is characterised by persistent respiratory symptoms and lung airflow limitations. Given the progressive nature of COPD, early symptoms are often ignored by most patients until more severe late-stage symptoms occur. Often in clinical practices, patient. history and a clinical examination are relied upon to diagnose COPD, making it easy to miss the early warning.

signs of the disease. Standardising the diagnosis by use of a spirometer test as the first stage of intervention for patients experiencing early-stage symptoms is critical to ensure early diagnosis and treatment. Adding to the conversation Dr. A.K. Singh, Director & HOD of Pulmonary Medicine at a hospital in Lucknow. said, “Administering a lung function test, specifically a spirometry test, can help avoid a delayed COPD diagnosis, mismanagement of the condition and ultimately prevent more severe flare-ups of the disease. So, for regions as well as populations that display high susceptibility to respiratory diseases like COPD, and are experiencing persistent respiratory symptoms, a spirometry test can help greatly. While the causes for respiratory ailments may not completely be in one’s control, being alert and aware for timely detection and diagnosis is important.”

Recently, considerable progress has been made to innovate and bring in devices that can improve the accessibility of spirometers to every pocket of the country by introducing elements of portability as well as wireless functionalities. Commenting on the access and innovation in spirometer devices, Dr. Jaideep Gogtay, Global Chief Medical Officer, Cipla Ltd. said, “Spirometers have proved to be instrumental in the early and accurate diagnosis of COPD. In order to bridge the access gap in spirometers, Cipla launched Spirofy®, India’s first pneumotach based portable, wireless spirometer which significantly increased access to accurate spirometry across the country. Spirofy® has been tested in Indian patients and has been found to be as accurate as the gold-standard spirometer in diagnosing COPD with a 97% sensitivity 3 .”