Declining rates of spirometry testing is posing a problem for COPD diagnosis and management, writes Rael Rivers, acting chief executive of Respiratory Care WA and Dr Li Ping Chung, Respiratory Consultant at Fiona Stanley Hospital.
We’re seeing fewer spirometry tests being done – and that’s a problem.
In 2024, Australia introduced the first Chronic Obstructive Pulmonary Disease (COPD) Clinical Care Standard which sets out best practice care for patients. A key component is the emphasis on spirometry as an essential diagnostic tool for assessing symptoms, disease severity and comorbidities.
Without spirometry, too many people are missing out on an accurate COPD diagnosis and the chance for early treatment that can significantly improve outcomes.
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The reasons behind the decline are complex, but the way forward is clear: keep spirometry front and centre, equip GPs with the tools and pathways they need, and invest in proven models of care, such as Respiratory Care WA’s Respiratory Hubs.
Declining spirometry rates
Earlier this year, the Atlas Focus Report: COPD by the Australian Commission on Safety and Quality in Health Care, highlighted a troubling trend – a 31% drop in spirometry testing across Australia between 2015/16 and 2022/23. In WA the decline was sharper at 39%.
This decline is particularly concerning given that spirometry remains the only reliable way to definitively diagnose COPD. Without this essential test, patients face delayed or incorrect diagnosis, leading to worse health outcomes and reduced quality of life.
It is likely that several factors have contributed to the decline including:
- High equipment and maintenance costs for clinics
- Spirometry being resource intensive and time consuming
- Reduced prioritisation or awareness of spirometry in COPD diagnosis
- Limited access to trained and experienced clinicians and scientists capable of interpreting tests.
Interpreting spirometry results and developing tailored treatment plans demands years of experience and specialised training.
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This expertise is crucial to ensuring accurate diagnosis and effective, personalised care plans. Shortcutting this process risks misdiagnosis, unnecessary patient harm and further delays in receiving appropriate treatment.
While the health system, including general practice, is already under
Supporting GPs
The decline in spirometry testing poses a significant challenge to COPD diagnosis and management in Australia, but the solution is within reach.
By supporting GPs, backing proven service models and outreach programs, ensuring sustainable funding, and prioritising spirometry – ideally by advocating to government policymakers and leaders to make it mandatory – we can turn the tide and improve health outcomes for thousands of Australians living with COPD.
ED: Respiratory Care WA’s Respiratory Hubs are integrated hubs that combine lung function testing, specialist review and reporting, and education. They operate in Perth and the South West.
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