Spirometry test helps patients improve lung function

Dr. James Kohlenberg, M.D.

Spirometry testing on patients with respiratory symptoms helps Dr. James Kohlenberg plan follow-up treatment, provide patient education on smoking cessation and increases patients’ medication compliance.

Spirometry is beneficial when determining the extent of pulmonary diseases for patients with symptoms such as shortness of breath, wheezing and persistent coughing, Dr. Kohlenberg said. The test is important because many doctors have patients with asthma as well as older patients who have smoked or continue to do so.

Medical assistants in his office have been trained to give the spirometry test. “The test is easy, the machines are inexpensive and the computer read-outs are readily available,” he said. The read-outs help Dr. Kohlenberg show his patients their lung function and how it can improve over time with subsequent testing.

“Spirometry is accurate and gives reproducible results so the physician can diagnose and monitor pulmonary disease.”

Frequently, people use the pulmonary function testing as feedback. And they’ve based their actions on this feedback, Dr. Kohlenberg said. “By knowing their own function, they’re able to own their disease and make decisions to help self manage their disease, whether it’s asthma or pulmonary disease.”

Discussing smoking cessation with patients

The main cause of Chronic Obstructive Pulmonary Disease (COPD) is smoking. Dr. Kohlenberg said, a component of COPD is reversible with medication. “Smoking cessation will improve the reversible component and slow down the progression of loss of function,” he said. Therefore, “it’s important to show patients who smoke their loss of function compared to normal and to also demonstrate the reversible proportion of their loss that could be eliminated.”

He asks about smoking at every patient encounter and documents it on the medical record. He also counsels patients about smoking cessation and sometimes prescribes medication.

Follow up is also critical. Patients with severe respiratory disease are seen as often as monthly. Those with moderate disease can be seen every three or four months.

With minimal disease, yearly visits are sufficient, Dr. Kohlenberg said. Spirometry is usually measured once or twice a year.

Dr. Kohlenberg and his medical assistants actively counsel patients. “We give them action plans for health. The patient is involved in developing a strategy to achieve specific goals that are timely and achievable.”

“And both patient and caregiver work together to generate ideas to overcome barriers,” he said.

The added benefit of spirometry testing is medication compliance “because patients know they improve when they take their medications regularly,” he said.