Spirometry is a component of the diagnosis and management of respiratory conditions in primary care and should ideally be performed via referral to a primary care network respiratory diagnostic service or community diagnostics centre (CDC) with expertise in the diagnosis of the most common respiratory conditions and of less common diagnoses. Where limited resources create a challenge for testing everyone with a new suspected diagnosis of asthma, those with an intermediate probability should be prioritised for spirometry and also FENO where available.
Date for review: 23rd October 2025
The common chronic respiratory disorders diagnosed in primary care—asthma and chronic obstructive pulmonary disease (COPD)—are both characterised by airway obstruction. In asthma, this varies markedly with time and treatment, while in COPD, the airway obstruction is typically fixed and permanent. Some people have fixed obstruction with some degree of reversibility—the so-called asthma COPD overlap syndrome (ACOS).
According to the Global Initiative for Asthma (GINA) asthma control is assessed in two domains: symptom control and risk of adverse outcomes. Poor symptom control is budensome to patients and increases the risk of exacerbations, but patients with good symptom control can still have severe exacerbations.[1]
In this article Angela Wixey discusses a local programme of work that was established to unravel the risk factors associated with under- and over- diagnosis of COPD. The service was operated by a Respiratory Nurse Specialist (RNS) credited by the Association of Respiratory Technology and Physiology (ARTP) in spirometry who examined 375 patients in five practices across the county over 9 months.
This short FAQ helps to answer some of your questions regarding spirometry in primary care during the COVID-19 pandemic. For further information please visit the ARTP website.
Guidance was published in April 2021 regarding the reinstatement of spirometry services during and post-COVID-19. The guidance aims to minimise risk to patient and healthcare professional. Our Spirometry Q&A may help answer some of your questions.