Spirometry

Description:

Our spirometry measure uses claims data to determine the percentage of Asthma and COPD patients aged 5 and older with at least one spirometry test in the measurement year or the year prior. A higher proportion indicates better performance as reflected by appropriate guideline-based care.

Population Specifics:

• Asthma patients, regardless of severity, aged 5 years and older who are identified as having asthma, regardless of severity.
• COPD patients aged 40 years and older who are identified as having COPD.

Numerator/Denomenator:

• Numerator: All patients aged 5 years and older with COPD or Asthma that have at least one claim for spirometry in the measurement year or the year prior.
• Denominator: All patients aged 5 years and older with COPD or Asthma in the measurement year.

Rationale:

• COPD (GOLD 2023):
  • A diagnosis of CPPD should be considered in any patient who has dyspnea, chronic cough or sputum production, a history of recurrent lower respiratory tract infections, and/or a history of exposure to risk factors for the disease, but forced spirometry showing the presence of a post-bronchodilator FEV1/FVC< 0.7 is mandatory to establish the diagnosis of COPD (Pg.. 28 Full Report).
  • Role of Spirometry in COPD (table 2.5, Pg. 35, Full Report)
    • Diagnosis
    • Assessment of severity of airflow obstruction (for prognosis)
    • Follow-up Assessment
      • Therapeutic decision
      • Identification of rapid decline
• Asthma (GINA 2022):
  • “Asthma is characterized by variable expiratory airflow limitation, i.e., expiratory lung function varies over time and in magnitude. To a greater extent than in healthy populations. In asthma, lung function may vary between completely normal and severely obstruction in the same patient. Poorly controlled asthma is associated with greater variability in lung function than well-controlled asthma” (Pg. 25 Full Report).
  • “Measure lung function before starting treatment, 3-6 months later, and then periodically, e.g., at least yearly in most patients” (Pg. 13 Pocket Guide).

Guideline Links:

• GOLD 2023 Guidelines: 2023 GOLD Report
• GINA 2022 Guidelines: 2022 GINA Main Report
• GINA 2023 Guidelines: 2023 GINA Main Report