TY - JOUR T1 - Detection of Alpha-1 Antitrypsin Deficiency by Respiratory Therapists: Experience with an Educational Program JF - Respiratory Care DO - 10.4187/respcare.02817 SP - respcare.02817 AU - James K. Stoller AU - Charlie Strange AU - Laura Schwarz AU - Tom Kallstrom AU - Rob Chatburn Y1 - 2013/10/07 UR - http://rc.rcjournal.com/content/early/2013/10/08/respcare.02817.abstract N2 - BACKGROUND: Alpha-1 antitrypsin deficiency (AATD) is under-recognized. We hypothesized that respiratory therapists (RTs) could help improve the detection rate of individuals with AATD. The AARC (American Association for Respiratory Care) and Alpha-1 Foundation recently collaborated to create an on-line AATD training program for RTs. This study aimed to determine: (1) the rate of RT enrollment in the training program; (2) the rates of detecting individuals with AATD referred for testing by RTs who took the on-line course (“trained RTs”), and; (3) the genotype distribution of referred individuals found to have AATD. METHODS: Patients referred by trained RTs submitted blood samples for AATD testing through the existing Alpha-1 Coded Testing (ACT) Study. The AARC sent the first 3 digits of trained RTs’ zip codes to the study data center. Investigators there matched those zip codes with those of patients in the ACT study who reported being referred to the study by an RT. The data center determined the number of these patients with AATD and their genotypes. Investigators then aggregated the data and calculated the RT enrollment rate, the rate of detecting individuals with AATD and the distribution of genotype results. RESULTS: Between 7/1/12 and 6/30/13, 378 RTs took the on-line program (mean 21/month), and 326 patients reported that they were referred for testing by an RT. Thirty four percent (111/326) of these referrals were by trained RTs (6.2/month). Of these 111 referred patients, 62 test blood kits were returned and analyzed (4/month). Two of these specimens (3.2%) were from patients identified as having severe AATD (2 PI*ZZ) and one with PI*SZ (serum level 14 micromolar). Twenty four percent were from PI*MZ heterozygotes. CONCLUSIONS: A program to educate RTs about AATD was associated with referral of patients for AATD testing and high rates of detecting individuals with severe deficiency of AAT. ER -