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Diseases

Screening for Chronic Obstructive Pulmonary Disease May Not Lead to Improved Outcomes

Strategic Insights

— 2 min read

A cluster-randomized trial investigating the impact of the COPD Assessment in Primary Care To Identify Undiagnosed Respiratory Disease and Exacerbation Risk (CAPTURE) tool on primary care clinician behavior and patient outcomes has yielded surprising results. The study, conducted by researchers from the University of Massachusetts, found that while the tool did not lead to significant improvements in patient outcomes for those with elevated screening scores, it did result in more appropriate use of healthcare resources.

Key Takeaways:

  • The trial included 49 usual-care and 51 intervention primary care practices, with 387 patients identified as screen-positive (CAPTURE+) and 1,028 patients identified as screen-negative (CAPTURE-).
  • For CAPTURE+ patients, no significant differences were noted between usual-care and intervention practices in the primary composite outcomes of spirometry referral/completion, new COPD diagnosis, or newly prescribed inhaled long-acting respiratory medication.
  • However, for the 1,028 CAPTURE- patients, similar primary and secondary outcomes were observed in both the intervention and usual-care groups.
  • A post-hoc analysis suggested that the pandemic may have diminished the impact of the CAPTURE tool on primary care practices, with fewer differences noted in clinician and patient outcomes between CAPTURE+ and CAPTURE- patients during the pandemic.
  • The CAPTURE tool was found to result in a more appropriate use of healthcare resources, particularly in the prepandemic period, with CAPTURE+ patients more likely to undergo spirometry referral completion.

Statistics:

  • 387 patients were identified as CAPTURE+ (screen-positive) and 1,028 patients were identified as CAPTURE- (screen-negative).
  • 49 usual-care and 51 intervention primary care practices participated in the trial.
  • The trial collected 12-month medical record and patient survey outcome data from patients with elevated screening scores or study spirometric abnormalities.
  • No significant differences were noted between usual-care and intervention practices in the primary composite outcomes for CAPTURE+ patients (absolute difference, 4.0%; 95% confidence interval, -6.9, 15.0; P = 0.47).
  • Only spirometry referral/completion was higher in the intervention group (absolute difference, 10.4%; 95% confidence interval, 0.1, 20.7; P = 0.0465).

Sources:

  • Martinez, F. J., et al. "Impact of the Capture Chronic Obstructive Pulmonary Disease Screening Tool In Us Primary Care: a Cluster-randomized Trial." American Journal of Respiratory and Critical Care Medicine, vol. 211, no. 5, 2025, pp. 789-802.
  • NewsRx. "Recent Findings from University of Massachusetts Has Provided New Information about Chronic Obstructive Pulmonary Disease (Impact of the Capture Chronic Obstructive Pulmonary Disease Screening Tool In Us Primary Care: a Cluster-randomized Trial)." TB & Outbreaks Week, June 10, 2025, p 414.

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