A mixed methods study to compare models of spirometry delivery in primary care for patients at risk of COPD

Background:To increase recognition of airflow obstruction in primary care, we compared two models of spirometry delivery in a target group at risk of chronic obstructive pulmonary disease (COPD).Methods:A 6 month qualitative/quantitative cluster randomised study in eight practices compared opportunistic spirometry by “visiting trained nurses” (TN) with optimised “usual care” (UC) from general practitioners (GPs) for smokers and ex-smokers, aged over 35 years. Outcomes were: spirometry uptake and quality, new diagnoses of COPD and GPs’ experiences of spirometry.Results:In the eligible target population, 531/904 (59%) patients underwent spirometry in the TN model and 87/1130 (8%) patients in the UC model (p