Effect on Attendance if Including Focused Information of Spirometry in Preventive Health Checks - a Randomized Controlled Trial in Primary Health Care

Background:

Lung diseases are among the most frequent and most serious ailments in Denmark. Chronic obstructive pulmonary disease (COPD) is the fourth most frequent cause of death and represents a significant burden on the health care system, the patients and their relatives. The National Board of Health in Denmark recommends spirometry to all individuals over 35 years who present at least one respiratory symptom (dyspnea, cough, wheeze or sputum production) or risk factors (prior or current smoking or relevant occupational exposure) in order to facilitate early detection of COPD. However approximately 200,000 citizens with COPD remain undiagnosed and unknown to the health care system.

Preventive health checks including spirometry can be used to detect lung diseases earlier. In a Danish municipality, the Check your Health Preventive Programme (CHPP) was initiated, offering preventive health checks to all 30 to 49 year-old citizens. This health promotion program provides the unique opportunity to evaluate single components of preventive health check in a real-life setting. Only a few previous studies have included spirometry in a preventive health check.

Over time the attendance at preventive health checks has decreased and at present the response rate is approximately 50%. Little is known about initiatives that can influence the attendance rate according to preventive health checks.

The aim of the study is to examine whether focused information on spirometry in the invitation material will influence the attendance in preventive health checks. The investigators hypothesize that spirometry as part of the preventive health check will increase the attendance in CHPP from 53% to 58% and the increase will be among prior and current smokers.