Adults referred to specialist respiratory outreach clinics in regional and remote Queensland

Abstract

Introduction/Aim: Australians living in rural and remote areas are at significantly increased risk of disease-associated morbidity and mortality relative to Australians living in urban areas. Health gaps are further heightened among Aboriginal and/or Torres Strait Islander Peoples (First Nations) who are disproportionately affected by chronic diseases. Our aim was to describe the burden of disease and lung function of adults living in regional and remote Queensland who attended a specialist respiratory outreach service, determine the impact demographic factors and respiratory diagnosis have on lung function, and evaluate the impact of the service on lung function. Methods: Retrospective 8-year cohort study (February 2012 to March 2020) of outreach clinics at regional and remote sites across Queensland, involving 1765 adults (1113 First Nations). Patient demographics, burden of disease, baseline and follow-up lung function were reported. Results: Mean forced expiratory volume in 1 second (FEV1) was clinically abnormal (-1.81 Z-scores) at baseline, while forced vital capacity (FVC), FEV1/FVC% and gas diffusing capacity (DLCO) (-1.44; -1.06; -1.45 Z-scores) were within the clinically normal range. 78% of patients were assigned a respiratory diagnosis. First Nations lung function was higher than that reported by other studies in the Northern Territory. Factors that significantly influenced lung function were smoking, second-hand household smoke exposure, below normal BMI, asthma, COPD, bronchiectasis, and pulmonary hypertension. 40% of patients (709/1765) were seen for follow-up. At follow-up at least 3 months after baseline, FEV1 and FVC were found to have significantly improved, FEV1/FVC% significantly reduced, with no change to DLCO. Patients with COPD had reduced FEV1 improvement than patients without COPD, while underweight and obese patients had lower FVC improvement than normal weight patients. Conclusion: First Nations adults in regional and remote Queensland have higher lung function than in previous studies, with halted lung function decline following specialist care at outreach clinics.L6350675732021-05-28 <br />