As COPD Awareness Month continues throughout November, the COPD Alliance (www.copd.org) again is providing free tools and resources to help clinicians battle COPD. This year the COPD Alliance is also launching the “Destroy the Pack, Don’t Look Back” photo contest which is asking people to submit original photos depicting the most creative way to destroy cigarettes, all in an effort to encourage smokers to quit. People can participate in the contest by visiting the COPD Alliance Facebook page at http://bit.ly/UyyP9E.
An estimated 24 million Americans have chronic obstructive pulmonary disease (COPD), half of whom remain undiagnosed, and the disease is the third leading cause of death in the United States.
What Is COPD?
Chronic obstructive pulmonary disease is a common preventable and treatable lung disease that causes problems with breathing. Patients with COPD have trouble pushing used air out of their lungs, making it difficult to take in healthy new air. COPD includes chronic bronchitis, emphysema, or both.
The most common cause of COPD is cigarette smoking—a behavior that we can work to prevent and help our patients overcome. Genetic factors or environmental and occupational exposures also may play a role in the development of COPD.
Coughing, with or without sputum, and breathlessness are the first symptoms patients generally notice. Over time, the breathlessness can worsen, sometimes to the point that dressing and bathing become difficult. Increased respiratory effort can cause fatigue with everyday activities.
Screening and Diagnosis
The first step in identifying patients with COPD is a detailed medical and work history, physical examination, and use of a validated COPD screening tool. Primary care clinicians may perform an in-office spirometry test to confirm the diagnosis of COPD.
Changing the Face of COPD
A change in disease burden
COPD is currently the fourth leading cause of death in the United States. Although the overall financial burden of COPD has yet to be determined, the total economic cost of COPD is expected to be $49.9 billion by 2010. This includes $29.5 billion in direct health-care expenditures and $20.4 billion in indirect costs.
A change in perception
A wide perception persists that COPD is a disease of the elderly, especially elderly men.2 In reality, COPD affects both men and women, many of whom are of working age.3 The typical patient with COPD resembles any chronic smoker aged 40 years or older. Many of these patients will be in their late 40s to 50s and still working full time. Many patients will continue to do all or most of their typical activities but find they limit exercise or exertion. They have often recently complained of recurrent episodes of prolonged or severe colds or chest colds. However, when speaking with clinicians, they may say they are fine and attribute their symptoms to increasing age or lack of physical fitness.
An estimated 24 million Americans may have COPD. Could your patient be one of them?
Screening for COPD using a validated screening tool is an important step in identifying patients who may be at risk for COPD.
The COPD screening tool is easy to use and can be self-administered by the patient in a clinician's office. Currently, there are two validated screening tools. Both tools involve five questions related to a patient's smoking history and symptoms. The questions are scored based on the patient's risk for COPD.
The COPD Alliance provides clinicians access to a validated COPD Population ScreenerTM (COPD-PS) online. Clinicians can download the COPD-PS (English and Spanish versions) for use in their offices or instruct patients to take the electronic version online.
Screening alone does not confirm a COPD diagnosis. However, using the final screening score, clinicians can determine if a patient should undergo spirometry testing to confirm a COPD diagnosis. All patients who score 5 or greater on the validated screener should undergo spirometry testing to confirm diagnosis.
Taking Action Can Make a Difference
Although there is no cure for COPD, symptoms can be controlled to improve a patient’s quality of life. The lung and airway damage cannot be repaired,1 but all of the symptoms of COPD can be reduced if you, as a clinician, take action. With your help, your patients can live well with COPD.
Steps for better living with COPD
Exercise and good nutrition
Flu (influenza) and pneumonia vaccinations
An understanding of COPD treatments and medicines