• Anthony Chapron, Emilie Andres, Laure Fiquet, Fabienne Pelé, Emmanuel Allory, Estelle Le Pabic, Aurélie Veislinger, Lisa Le Guillou, Stéphanie Guillot, Bruno Laviolle, and Stéphane Jouneau.
• Department of General Practice, University of Rennes, Centre Hospitalier Universitaire (CHU) Rennes, Rennes; UMR_S 1085, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Recherche en Santé, Environnement et Travail (IRSET), Rennes.
• Br J Gen Pract. 2023 Dec 1; 73 (737): e876e884e876-e884.

BackgroundWorldwide, chronic obstructive pulmonary disease (COPD) remains largely underdiagnosed.AimTo assess whether the use of Global Initiative for Chronic Obstructive Lung Disease (GOLD) questions and COPD coordination, either alone or combined, would detect new COPD cases in primary care.Design And SettingGPs in Brittany, France, systematically enrolled patients aged 40-80 years over a 4-month period in this French multicentre cluster randomised controlled study.MethodGPs were randomly allocated to one of four groups: control (standard of care), GOLD questions (adapted from symptoms and risk factors identified by GOLD), COPD coordination, and GOLD questions with COPD coordination. New cases of COPD were those confirmed by spirometry: post-bronchodilator forced expiratory volume in 1 second over forced vital capacity of <0.7.ResultsIn total, 11 430 consultations were conducted by 47 GPs, who enrolled 3162 patients who did not have prior diagnosed asthma or COPD. Among these, 802 (25%) were enrolled in the control, 820 (26%) in the GOLD questions, 802 (25%) in the COPD coordination, and 738 (23%) in the GOLD questions with COPD coordination groups. In the control group, COPD was not evoked, and no spirometry was prescribed. All new cases of COPD diagnosed (n = 24, 0.8%) were in the intervention groups, representing 6.8% of patients who performed spirometry. Statistically significantly more new cases of COPD were detected with COPD coordination (P = 0.01).ConclusionInterventions that can be easily implemented, such as the GOLD questions and COPD coordination, can identify new cases of COPD. Studies are needed to identify the most appropriate case-finding strategies for GPs to detect COPD in primary care for each country.© The Authors.

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