National survey of spirometer ownership and usage in general practice in Australia

Objectives and background: Despite the lack of data, it is believed that spirometry is underutilised in general practice. The aim of the present study was to determine the availability of spirometry and the level of spirometry training in general practice throughout Australia and compare with international data. Design: In total, 5976 general practices throughout Australia were sent a questionnaire requesting details of spirometer ownership, usage, and the level and source of spirometry training undertaken. To exclude response bias, a follow-up telephone survey was conducted of 160 practices that did not respond to the initial survey. Results: Of practices, 19.5% (1125) responded to the initial survey with 64.2% (722) of these owning a spirometer and 83.9% (134) in the follow up sample. Common reasons for not owning a spirometer were equipment cost (53.3%) and insufficient Medicare remuneration (32.8%). Most practices (67.0%) performed one or more tests per week. Practices commonly utilised spirometry to diagnose (89.5%) and manage (93.9%) asthma, assess breathlessness (83.4%), and to detect and manage other respiratory diseases such as COPD (77.7%). Spirometer accuracy was never checked using a syringe by 77.8% of practices and 40% do not test a healthy subject as part of their quality assurance programme. Spirometry training was received most commonly through courses run by general practice organisations (38.2%), and the duration of training courses was <2h in 40% of cases. Conclusion: Despite high spirometer ownership in general practice, the frequency of use is low. Low rates of verification of accuracy and performance suggest the need for reliable, stable spirometers to be available to general practitioners. Regular and more comprehensive training in spirometry is needed.