Long wait for chronic obstructive pulmonary disease test

The Quebec Lung Association (APQ) is asking the Legault government to reduce the wait for spirometry, a test used to diagnose chronic obstructive pulmonary disease (COPD). Patients wait up to three years before they can get one, according to data obtained by The duty.

The wait for a spirometry is indeed 36 months in the local services network (RLS) of Chicoutimi, indicates the CIUSSS of Saguenay–Lac-Saint-Jean. It amounts to 15 months in the RLS of Jonquière.

At the Hôtel-Dieu de Sorel, “the oldest request” for spirometry dates back 20 months, according to the CISSS de la Montérégie-Est.

The wait is shorter at the CISSS de Lanaudière. People in whom COPD is suspected — a disease that includes chronic bronchitis and emphysema and which manifests itself in particular by shortness of breath and chronic cough — must wait a year at the regional hospital centre.

The situation is similar to the Lakeshore hospital, according to information from the CIUSSS de l’Ouest-de-l’Île-de-Montréal.

« It’s hell to have a spirometry test, » said the director general of the APQ, Dominique Massie. We have wait times that have no bearing in Quebec. »

The test is simple: just blow into a device that measures the maximum speed at which air can be expelled from the lungs and the amount of air exhaled.

According to the APQ, spirometry should be performed within 90 days in the event of potential COPD. A target that Dominique Massie describes as « reasonable ».

The Dr Jonathan Lévesque, pulmonologist at Maisonneuve-Rosemont Hospital, finds the wait times reported for this type of test, “the only one approved in the guidelines” for the diagnosis of COPD, “extremely discouraging”, he specifies. .

He recalls that patients suffering from this disease weigh heavily in the health system. They must be hospitalized when their respiratory symptoms worsen. Quebec hospitals have been overflowing lately.

« In 2018-2019, before the pandemic, the exacerbation of COPD was the leading cause of hospitalization in Quebec, if we exclude childbirth, » says Dr.r Levesque.

The disease has become, with bronchitis, in 2020-2021, the fifth cause of hospitalization (after childbirth, COVID-19, heart failure and acute myocardial infarction), according to the Canadian Institute of health information.

Unequal waiting times

Access to spirometry varies by region. At the CIUSSS de l’Est-de-l’Île-de-Montréal, the wait is two to six months « depending on the establishment and the level of priority given to each case ». It varies between five and eight and a half months at the CIUSSS du Centre-Sud-de-l’Île-de-Montréal.

At the CISSS de la Montérégie-Ouest, patients only wait one day before undergoing spirometry at the Anna-Laberge hospital (four months at the Suroît hospital). The test is offered in 10 working days in Outaouais, assures the regional CISSS.

The CISSS de la Montérégie-Est, which manages the Hôtel-Dieu de Sorel, explains the long wait by the shortage of respiratory therapists, who perform spirometry examinations. The Sorel region, on the territory of the CISSS, is “the most affected” by the lack of this type of professional, we add.

Respiratory therapists have also been in greater demand during the waves of COVID-19. “Unfortunately, ambulatory activities are affected, which causes an increase in the care interval,” writes the CISSS de la Montérégie-Est.

The CIUSSS du Saguenay–Lac-Saint-Jean says it is working « actively to reduce waiting lists for patients in Chicoutimi and Jonquière » by offering them « appointments in [ses] facilities of other RLSs » in its territory. Depending on the healthcare facility, the expectation differs. It is nil in Roberval and varies between one and two months in La Baie, Alma and Dolbeau-Mistassini.

The CISSS de la Montérégie-Centre currently lists 65 patients waiting for spirometry, some of whom “for almost a year”. « Spirometry is a non-urgent test, » an email said. However, we are trying to reduce the waiting list by adding appointment slots when respiratory therapists are available in the evenings and on weekends. »

The Dr Jonathan Lévesque recognizes that this test is not “a medical emergency”. But it remains “essential for diagnosing COPD and asthma,” he says.

“Because of the long wait, doctors have no choice most of the time to start treatment without having the official diagnosis by spirometry,” he says. Some people are going to be wrongly treated, and that doesn’t help reduce costs in the health care system. »

COPD is the fourth leading cause of death in Canada, according to the APQ. Nearly 600,000 Quebecers have been diagnosed with the disease.

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