Timely spirometry is associated with all-cause mortality and tailored care in initiators of chronic respiratory treatment

<bold>Background:</bold> Spirometry is the gold standard to diagnose COPD, yet it remains underused in clinical practice. <bold>Aim:</bold> To investigate the association between timely spirometry (at treatment initiation) and short-acting bronchodilator (SABD) use in chronic respiratory treatment initiators and to assess the impact of timely spirometry on all-cause mortality. <bold>Methods:</bold> Adult initiators of chronic respiratory medication were identified in Belgian nationwide data. The association between timely spirometry and SABD-only use and the impact of timely spirometry on survival were assessed using multivariable logistic regression and Cox regression, respectively. Analyses were adjusted for sex, age, smoking status and comorbidities. <bold>Results:</bold> Among 146,205 chronic treatment initiators (aged 64 years, 58% female), 65.3% did not undergo spirometry. While general practitioners prescribed 81.1% of initiated treatments, they performed only 5.1% of all spirometry tests. People who received spirometry at treatment initiation were 65% less likely to use SABD-only (aOR 0.35, 95%CI 0.33-0.36) and had a 34% reduced mortality risk (aHR 0.66, 95%CI 0.63-0.70), compared to patients who did not receive spirometry during the study. <fig><object-id>erj;66/suppl_69/PA2557/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig> <bold>Conclusion:</bold> Only one in three chronic treatment initiators received spirometry. Timely spirometry was significantly associated with a better prognosis, likely through better-tailored care.