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Addressing the challenge of early COPD diagnosis at the primary care level: Reflections from public health policies to healthcare system development

  • Zhaoqian GONG ,
  • Wenqu ZHAO ,
  • Yaoxin CHEN ,
  • Haijin. ZHAO
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  • Chronic Airways Diseases Laboratory,Department of Respiratory and Critical Care Medicine,Nanfang Hospital,Southern Medical University,Guangzhou 510080,Guangdong,China

Received date: 2025-05-18

  Online published: 2025-08-28

Abstract

Chronic obstructive pulmonary disease (COPD) is a widespread chronic inflammatory respiratory condition characterized by high morbidity, affecting approximately 100 million individuals in China. It represents a significant public health concern and imposes considerable socioeconomic costs. Historically, the rate of early diagnosis for COPD has been low, presenting a persistent challenge in clinical practice. Enhancing early detection therefore remains a critical and urgent priority. This study provides a comprehensive review of existing national-level policies aimed at improving early COPD diagnosis within primary healthcare settings, as well as their regional implementation status. The dual objectives of this analysis are to support the enhancement of early diagnosis rates and to contribute to the optimization of COPD clinical management frameworks.

Cite this article

Zhaoqian GONG , Wenqu ZHAO , Yaoxin CHEN , Haijin. ZHAO . Addressing the challenge of early COPD diagnosis at the primary care level: Reflections from public health policies to healthcare system development[J]. The Journal of Practical Medicine, 2025 , 41(16) : 2441 -2446 . DOI: 10.3969/j.issn.1006-5725.2025.16.001

References

[1] ADELOYE D, SONG P, ZHU Y, et al. Global, regional, and national prevalence of, and risk factors for, chronic obstructive pulmonary disease (COPD) in 2019: A systematic review and modelling analysis[J]. Lancet Respir Med, 2022,10(5):447-458. doi:10.1016/s2213-2600(21)00511-7
[2] STOLZ D, MKOROMBINDO T, SCHUMANN D M, et al. Towards the elimination of chronic obstructive pulmonary disease: A Lancet Commission[J]. Lancet, 2022,400(10356):921-972. doi:10.1016/s0140-6736(22)01273-9
[3] FANG L, GAO P, BAO H, et al. Chronic obstructive pulmonary disease in China: A nationwide prevalence study[J]. Lancet Respir Med, 2018,6(6):421-430. doi:10.1016/s2213-2600(18)30103-6
[4] WANG C, XU J, YANG L, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in China (the China Pulmonary Health [CPH] study): A national cross-sectional study[J]. Lancet, 2018,391(10131):1706-1717. doi:10.1016/s0140-6736(18)30841-9
[5] 王凌伟, 陈荣昌. 基层慢阻肺早期筛查和早期诊断的现状与对策[J]. 中华健康管理学杂志, 2022,16(4):217-221.
[6] 彭显如, 黄敏於, 赵文驱, 等. 首诊慢阻肺错失早期诊断时间与疾病严重程度相关[J]. 南方医科大学学报, 2018,38(12):1448-1452.
[7] CHEN Q, FAN Y, HUANG K, et al. Cost-effectiveness of population-based screening for chronic obstructive pulmonary disease in China: A simulation modeling study[J]. Lancet Reg Health West Pac, 2024, 46:101065. doi:10.1016/j.lanwpc.2024.101065
[8] 李晓晨, 刘先胜. 慢性阻塞性肺疾病全球创议2018更新与临床实践[J]. 临床内科杂志, 2018, 35(11):729-732.
[9] WANG C, QI W, YANG T, et al. The care cascade of chronic obstructive pulmonary disease in China: A cross-sectional study of individual-level data at enrolment into the national 'Happy Breathing' Programme[J]. EClinicalMedicine, 2024,74:102597. doi:10.1016/j.eclinm.2024.102597
[10] 唐星瑶, 黄可, 李薇, 等. 河南省驻马店市基层医疗机构医生慢性阻塞性肺疾病知识掌握情况及影响因素调查研究[J]. 中华全科医师杂志, 2022,21(5):422-429.
[11] 文富强, 雷玲子. 我国临床医生对慢性阻塞性肺疾病认知现状与应对策略[J]. 西部医学, 2021,33(1):1-3.
[12] 潘君, 杨路莹, 胡宁, 等. 基层医疗卫生机构医务人员对慢性阻塞性肺疾病诊疗能力的调查研究[J]. 中国临床医生杂志, 2024, 52(6):645-650.
[13] 上海市医学会呼吸分会基层呼吸疾病防治联盟. 上海市社区医生肺功能知识问卷调查[J]. 中国呼吸与危重监护杂志, 2018, 17(2):165-168.
[14] 张冬莹, 高怡, 简文华, 等. 肺功能检查技术在基层医疗卫生机构推广可行性及建议[J]. 中国全科医学, 2020, 23(29):3638-3643.
[15] 中国县域慢性阻塞性肺疾病筛查专家共识编写专家组, 中国医师协会呼吸医师分会基层工作委员会. 中国县域慢性阻塞性肺疾病筛查专家共识(2020年)[J]. 中华医学杂志, 2021, 101(14):989-994.
[16] 国家卫生健康委员会. 健康中国行动——慢性呼吸系统疾病防治行动实施方案(2024—2030年)(第二部分)[J]. 中国病毒病杂志, 2025, 15(2):157.
[17] 国家卫生健康委、财政部、国家中医药局、国家疾控局. 关于做好2024年基本公共卫生服务工作的通知[J]. 中华人民共和国国家卫生健康委员会公报, 2024(9):8-10.
[18] 李薇, 黄可, 潘君, 等. “三大国家级项目”共筑中国慢性阻塞性肺疾病防治长城[J]. 中国临床医生杂志, 2022, 50(7):753-754.
[19] 王群, 叶梅毅, 李祖平, 等. 区域医学检验中心信息化平台建设的发展现状与挑战[J]. 临床医药实践, 2025, 34(1):43-46.
[20] DAS N, HAPPAERTS S, GYSELINCK I, et al. Collaboration between explainable artificial intelligence and pulmonologists improves the accuracy of pulmonary function test interpretation[J]. Eur Respir J, 2023,61(5):2201720. doi:10.1183/13993003.01720-2022
[21] 中华医学会, 中华医学会杂志社, 中华医学会全科医学分会, 等. 慢性阻塞性肺疾病基层诊疗指南(2018年)[J]. 中华全科医师杂志, 2018,17(11):856-870.
[22] MA Y, ZHAN Z, CHEN Y, et al. Machine learning-assisted construction of COPD self-evaluation questionnaire (COPD-EQ): A national multicentre study in China[J]. J Glob Health, 2025, 15:4052. doi:10.7189/jogh.15.04052
[23] 梁雪玲, 何平, 曹晶晶, 等. 医院-社区-家庭-个人的慢阻肺防控体系对慢阻肺患病率、知晓率及准确性的影响[J]. 广东医学, 2023,44(10):1279-1282.
[24] LEVENTHAL H, LEVENTHAL E A, CONTRADA R J. Self-regulation, health, and behavior: A perceptual-cognitive approach[J]. Psychol Health, 1998, 13(4):717–733. doi:10.1080/08870449808407425
[25] XIONG C, JIANG C, ZHANG H, et al. Self-management and illness perception among cervical cancer patients: A cross-sectional study[J]. Int J Nurs Pract, 2023,29(3):e13134. doi:10.1111/ijn.13134
[26] HUANG L M, TAN C Y, CHEN X, et al. A Qualitative Study on Illness Perception and Coping Behaviors Among Patients with Chronic Obstructive Pulmonary Disease: Implications for Intervention[J]. Int J Chron Obstruct Pulmon Dis, 2024, 19:2467-2479. doi:10.2147/copd.s473790
[27] WU J, NIU H, DUAN S, et al. Current status of pharmacists in community pharmacies in China in the health management of chronic respiratory diseases[J]. BMC Public Health, 2025, 25(1):1052. doi:10.1186/s12889-025-22272-8
[28] 张春瑜, 贾存波, 方方, 等. 继续教育对基层医务人员有关慢性阻塞性肺疾病相关认知的影响研究[J]. 中国临床医生杂志, 2022, 50(2):145-147.
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