Case-finding for COPD in Primary Care: A qualitative study of patients’ perspectives

Alexandra Enocson, Kate Jolly, Rachel Jordan, David Fitzmaurice, Sheila Greenfield, Peymane Adab, Kar Cheng, B.G. Cooper, Amanda Daley, Andrew Dickens, Joanne O'Beirne-Elliman, Shamil Haroon, Sue Jowett, Kiran Kalirai, J Marsh, M.R Miller, R Riley, Robert Stockley, Alice Turner

Research output: Contribution to journalArticlepeer-review

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COPD is a leading cause of morbidity and mortality, yet it remains largely under diagnosed. Case-finding is encouraged by many professionals, but there is a lack of information on the patients’ views and perspectives. Semi-structured interviews were conducted with adults, aged 40 years or more with a history of smoking, who were eligible and invited for case-finding for COPD as part of a large UK primary care trial. Forty-three people, including those who consented or declined participation and those with and without COPD after screening, were interviewed. Interviews were transcribed and analysed using the Framework method, revealing two main categories of themes: patients' views on COPD case-finding and barriers to case-finding. Overall, case-finding was deemed important and beneficial. Participants highlighted the need for screening activities to be convenient for patients, but perceived that GPs lacked the time and accessing appointments was difficult. Desire for a health check among symptomatic patients facilitated participation in case-finding. Psychological barriers to engagement included denial of ill-health or failure to recognise symptoms, fear of the “test”, and lung symptoms being low on the hierarchy of patient health complaints. Mechanical barriers included providing care for another person (and therefore being too busy), being unable to access GP appointments, and lacking feedback of spirometry results or communication of the diagnosis. In conclusion, patient engagement with case-finding may be limited by denial or lack of recognition of symptoms and physical barriers to attendance. Increasing public awareness of COPD risk factors and early symptoms may enhance case-finding.
Original languageEnglish
Pages (from-to)1623—1632
JournalInternational journal of chronic obstructive pulmonary disease
Issue number13
Publication statusPublished - 17 May 2018


  • chronic obstructive pulmonary disease
  • screening
  • qualitative research
  • primary care


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