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Not uncommonly, a patient who receives a diagnosis of chronic obstructive pulmonary disease (COPD) and who receives ongoing bronchodilator therapy lacks confirmation of the diagnosis. In this 5-year study from three U.S. Veterans Affairs hospitals, researchers documented the extent of this phenomenon. About 5000 patients whose medical records already identified them as having COPD underwent spirometry for the first time. During the 2 years prior to spirometric testing, 3209 of these patients had been prescribed inhaled bronchodilators or corticosteroids; most received repeated prescriptions for short-acting bronchodilators or at least one prescription for a long-acting bronchodilator or inhaled steroid.
At spirometry, only 55% of patients ex…