The Czech National Programme for Early Detection of Chronic Obstructive Pulmonary Disease - interim results from the pivotal project

Aims and Objectives: Estimated prevalence of COPD in Czechia is ca 710,000 cases. However, only ca 250,000 are treated regularly. We aimed to analyze first interim data from the ongoing Czech National Programme for Early De­tection of COPD with emphasis on program effectiveness assessment. Methods: Seventy-three general practitioners (GPs) participate in pre-screening of high-risk patients, i.e., age 40-69 yrs, smoking history of ≥10 pack-years (PY) and perceived dyspnea during physical exercise. Patients screened positive were referred to one of the 32 cooperating pulmonologists where lung function tests, mMRC and CAT were performed. Diagnosis of COPD was established - along with deeper assessment of symptoms and lung functions - in accordance with the international standards. In this interim analysis, we assessed benefits of the ongoing program and the diagnostic yield of GPs9 patient referrals compared to patients screened directly by a pulmonologist upon their own will. Results: By 2020 Nov, 966 patients were pre-screened by GPs, of these, 446 (46%) were referred to a pulmonologist. Of the 446 referrals, 59.6% (266 patients) completed respiratory screening, along with 332 patients examined upon their own will. Of the 538 patients examined by a pulmonologist, 180 (33.5%) were newly diagnosed with COPD. The proportion of COPD-diagnosed patients strongly differed with positive ratios of 0.226 (GPs9 referrals) and 0.405 (own will). Most of the new COPD cases were men (61%) with 38.5 PY, 87% current smokers, GOLD stages I+II (83%) and group A (53%). Conclusion: The interim data showed the ongoing programme is highly effective and detects early stages of COPD.