Læknablaðið - 15.06.2012, Blaðsíða 29

RANNSÓKN
Þakkir
Loftfélagið veitti óskilyrtan vísindastyrk til verkefnisins. Fjárhags-
legur bakhjarl þess er lyfjafyrirtækið GlaxoSmithKline. Einnig
styrkti Vísindasjóður Félags íslenskra heimilislækna rannsókn-
ina. Þakkir fær Sveinn Ríkarður Jóelsson fyrir gerð gagnaskrán-
ingarkerfis. Einnig fá þakkir Sjúkrahúsið á Akureyri fyrir að veita
Guðrúnu Dóru Clarke rannsóknanámsleyfi og starfsfólk heilsu-
gæslustöðvarinnar á Akureyri fyrir veitta aðstoð við afhendingu
spurningalista.
Áhugasamir geta fengið nánari upplýsingar um spurningalista
frá höfundum.
Heimildir
1. Benediktsdottir B, Gudmundsson G, Jorundsdóttir KB,
Vollmer W, Gislason T. Hversu algeng er langvinn lungna-
teppa?- íslensk faraldsfræðirannsókn. Læknablaðið 2007;
93:471-7.
2. From the Global Strategy for the Diagnosis, Management
and Prevention of COPD, Global Initiative for Chronic
Obstructive Lung Disease (GOLD) 2010. goldcopd.org/. -
maí 2012.
3. Murray CJ. Lopes AD. Global mortality, disability, and
the contribution of risk factors: Global Burden of Disease
Study. Lancet 1997; 349:1436-42.
4. Nielsen R, Johannessen A, Benediktsdottir B, Gislason
T, Buist AS, Gulsvik A et al. Present and future costs of
COPD in Iceland and Noru'ay: results from the BOLD
study. Eur Respir J 2009; 34:850-7.
5. Magnússon S, Gislason T. Chronic bronchitis in Icelandic
males: prevalence, sleep disturbances and quality of life.
Scand J Prim Health Care 1999; 17:100-4.
6. Danielsson P, Olafsdóttir IS, Benediktsdóttir B, Gíslason
T, Janson C. The prevalence of chronic obstructive
pulmonary disease in Uppsala, Sweden - the Burden
of Obstructive Lung Disease (BOLD) study: cross-
sectional population-based study. Clin Respir J 2011. doi:
10.1111/j.l752-699X.2011.00257.x.
7. Hankinson JL, Odencrantz JR, Fedan KB. Spirometric
Reference Values from a Sample of the General US
Population. Am J Respir Crit Care Med 1999; 159:179-87.
8. Sigurdsson EL, Palsdottir K, Sigurdsson B, Jonsdottir S,
Gudnason V. Áhættuþættir hjarta- og æðasjúkdóma meðal
fimmtugra á Akureyri og í Hafnarfirði. Staða og áhrif
einfaldrar íhlutunar. Læknablaðið 2003; 89: 859-64.
9. Szatkowski L, Lewis S, McNeiII A, Coleman T. Is smoking
status routinely recorded when patients register with a
new GP? Fam Pract 2010; 27:673-5.
10. de Marco R, Accordini S, Marcon A, Cerveri I, Antó JM,
Gislason T, et al. European Community Respiratory
Health Survey (ECRHS). Risk factors for chronic obst-
ructive pulmonary disease in a European cohort of young
adults. Am J Respir Crit Care Med 2011; 183: 891-7.
11. Martin-Lujan F, Pinol-Moreso JL, Martin-Vergara N,
Basora-Gallisa J, Pascual-Palacios I, Sagarra-Alamo R, et
al. Effectiveness of a structured motivational intervention
including smoking cessation advice and spirometry
information in the primary care setting: The ESPITAP
study. BMC Public Health 2011; 11:859.
12. Stratelis G, Mölstad S, Jakobsson P, Zetterström O. The
impact of repeated spirometry and smoking cessation
advice on smokers with mild COPD. Scand J Prim Health
Care 2006; 24:133-9.
13. Stratelis G, Jakobsson P, Molstad S, and Zetterstrom O.
Early detection of COPD in primary care: screening by
invitation of smokers aged 40 to 55 years. Br J Gen Pract
2004; 54:201-6.
14. Schermer T, van Weel C, Barten F, Buffels J, Chavannes
N, Kardas P, et al. Prevention and management of chronic
obstructive pulmonary disease (COPD) in primary care:
position paper of the European Forum for Primary Care.
Qual Prim Care 2008; 16: 363-77.
15. Haahtela T, Tuomisto LE, Pietinalho A, Klaukka T, Erhola
M, Kaila M, et al. A10 year asthma programme in Finland:
major change for the better. Thorax 2006; 61:663-70.
ENGLISH SUMMARY
Prevalence of smoking and chronic obstructive pulmonary disease
among patients at the Akureyri Primary Care Center
Clarke GD1, Jonsson JS2-3, Olafsson M1, Joelsdottir SS4,Gudmundsson G35
Introduction: Even though smoking has decreased significantly over
the last few years, the majority of lcelanders 40 years of age or older
have a history of smoking. Limited information is available on respiratory
symptoms and diagnosis of chronic obstructive lung diseases (COPD)
in this group.
Material and methods: During a four week period at the Akureyri Prim-
ary Care Center all individuals above the age of 40 were given a ques-
tionnaire on smoking, respiratory symptoms and medical treatment.
There were a total of 416 individuals and the response rate was 63%.
Spirometry was done on those who had smoked.
Results: Of the 259 responders, 150 (57,9%) had a history of smoking.
In this group 117 (45,2%) had quit but 33 (12,7%) were still smoking.
Of those that had a history of smoking 16% had COPD according to
spirometry resuits and 2/3 did not have a previous diagnosis. Respira-
tory symptoms were more common with increasing obstruction. Of the
smokers 26% had never been advised by a physician to stop smoking.
A total of 14,3% of the whole group had a previous diagnosis of emphy-
sema, chronic obstructive pulmonary disease or chronic bronchitis.
Altogether 23,5% had previously been diagnosed with asthma, asthma-
tic bronchitis or allergic bronchitis.
Conclusion: A history of smoking was common among the primary
care patients. One in six who had a smoking history were found to have
COPD and the majority were unaware of the diagnosis. Respiratory
diagnoses were common. By spirometric evaluation many smokers are
diagnosed with previously unknown COPD.
Key words: primary care, lung disease, diagnosis, symptoms, smoking, spirometry, case finding.
Correspondence: Gunnar Guðmundsson, ggudmund@iandspitati.is
'Department of Respiratory Medicine National University Hospital, 2Akureyri primary care center, 3Gardabaer primary care center,4Faculty of Medicine
University of lceland. Akureyri University
LÆKNAblaðið 2012/98 353