Spirometry is a biomedical test to measure lung function in subject who (may) have a chronic respiratory condition. Performing the test requires a certain level of training and experience from the health care professional who conducts the test, and sufficient cooperation of the patient. Although the test is widely used in primary care in many countries, the quality of the test performance seems limited and needs improvement in order to avoid false-positive and false-negative test interpretations. In this study, the researchers investigated whether a combination of e-learning and bimonthly written performance feedback to family practice nurses and assistance regarding their spirometry tests improves the rate of adequate tests.

Inclusion Criteria for Family Practices:

• collaboration with Elkerliek Hospital Helmond through regional integrated care support service ('QUARTZ')
• purchased spirometer through this support service
• have implemented spirometry as a part of routine patient care

Inclusion Criteria for Patients:

• registered in one of the participating family practices
• performed a spirometry test as a part of routine care during the observation period of the study

Exclusion Criteria for Patients:

• age < 10 years