Description of a Dutch well-established asthma/COPD service for primary care

Introduction Diagnosing asthma and COPD is difficult, therefore many patients are still undiagnosed and untreated. In 2007, the Asthma/COPD(AC) service was implemented in The North of the Netherlands to advice general practitioner(GP)s in diagnosing, treating and managing their asthma and COPD patients by involving local pulmonologists. Aim To describe the AC service and the patient population Methods GPs can refer patients with evidence of respiratory problems to the AC service for assessment and advice. Patients complete a history questionnaire, the Clinical COPD Questionnaire (CCQ), the Asthma Control Questionnaire (ACQ), and spirometry is performed by a trained technician. The Pulmonologist inspects the data online, without seeing the patient, and sends the GP the results along with a diagnosis and treatment advice. Finally GPs discusses these results with their patients. Results Until now, the service has included ∼12.000 patients (mean age = 54±19 years, 44% male) from 359 GPs and ∼2000 new patients are included yearly. In 78% assessments, the pulmonologist was able to diagnose patients based on online information (45% asthma, 17% COPD, 7% asthma/COPD overlap). Conclusion This Dutch AC service has proven to be a feasible collaboration system between GPs and pulmonologists. This service might also be feasible for the support of GPs in other chronic diseases and countries. ![Figure][1] [1]: pending:yes