Opportunistic screening for COPD among socially marginalized patients

Abstract

Abstract Background Chronic obstructive pulmonary disease (COPD) is a common disease associated with premature death. Tobacco exposure is the main risk factor, but lower socioeconomic status, early life insults, and occupational exposures are also among the risk factors. Smoking cessation and early detection of COPD are crucial in order to improve outcomes. Socially marginalized people, facing homelessness, substance use disorder, and mental illness, are likely to have a higher risk of developing COPD, and, furthermore, experience barriers to healthcare access and consequently poorer outcomes. Objective This study aims to assess COPD prevalence and impact of opportunistic screening among hospitalized patients who are in contact with hospital social nurses. These patients constitute a group of patients with a high prevalence of psychiatric and somatic diseases, substance use, low life expectancy, and are socially marginalized. Methods The present prospective longitudinal study includes a clinical examination at baseline. Participants will have spirometry done and participate in interviews regarding risk factors, socioeconomic conditions, and respiratory symptoms. The 5-year follow-up assessment incorporates data from baseline and register data over the five years, including information on morbidity, use of COPD medication, hospital contacts, mortality, and socioeconomic factors. Anticipated results Referral for further diagnostic work-up and management after the screening, including COPD treatment and smoking cessation support, is expected to improve survival rates. As the study is still enrolling patients there are no preliminary findings. Trial Registration The study is registered at ClinicalTrials.gov, NCT04754308 with study status: “enrolling”