NIH SURVEY IDENTIFIES BARRIERS TO EFFECTIVE PATIENT-PROVIDER DIALOGUE ABOUT COPD

[Thomas3.20.2010]

 Lack of communication between patients and health care providers about chronic obstructive pulmonary disease (COPD) remains a major barrier to diagnosis of this disease, according to the results of a Web-based survey released today by the National Heart Lung, and Blood Institute (NHLBI) of the National Institutes of Health. More Americans, particularly smokers, are talking to their doctor or health care provider about the symptoms of COPD, which is an encouraging sign that awareness efforts are taking hold. Patients and providers, though, can still do more.

   "A good conversation between patients and providers about COPD can make a

  real difference for disease sufferers.  It's no secret that early diagnosis

  and treatment can improve daily living for those who have COPD - but you

  can't get there without an open line of dialogue in the exam room," said

  James Kiley, Ph.D., director of the NHLBI Division of Lung Diseases. "That's

  why patients and providers need to be aware of COPD, its risk factors and

  symptoms, how it affects daily life and what can be done to help get them

  back to doing the things they love."

  COPD, which in 2010 surpassed stroke to become the third leading cause of

  death in the United States, is a serious lung disease which over time makes

  it harder to breathe. It affects an estimated 24 million Americans, but as

  many as half of those affected remain undiagnosed. This is partially because

  symptoms of the disease - such as shortness of breath, chronic coughing or

  wheezing, production of excess sputum, or a feeling of being unable to take

  a deep breath - come on slowly and worsen over time, leaving many to dismiss

  their symptoms and delay seeking diagnosis and treatment until the disease

  is advanced.

   The survey found a dramatic increase in the numbers of current smokers, a

  key COPD risk group, who had discussed their symptoms with their doctors -

  from 42 percent in 2009 to 67 percent in 2013. Overall, 26 percent of adults

  who reported experiencing these symptoms stated they had not discussed these

  symptoms with their doctor or health care provider.  Physicians also missed

  opportunities; 82 percent of current smokers who reported symptoms had a

  conversation with their doctor about their smoking history, but only 37

  percent of former smokers, who are also at risk, reported a similar

  conversation.

   According to the survey, COPD awareness issues contribute to this missed

  dialogue. For example, three of the top reasons cited by people with COPD

  symptoms who did not talk to a doctor were "I did not think of it," "I've

  had these problems for years," and "these problems will just go way in

  time." Also, only 18 percent of symptomatic people who discussed their

  symptoms heard their provider mention COPD.

  "Regardless of positive developments, the challenge remains that more than

  1 in 3 Americans do not know what COPD is or how it affects them - and less

  than half understand that COPD can be treated," said Kiley. "COPD is the

  only major chronic disease where deaths are not decreasing. It is critical

  for people to understand whether they may be at risk and recognize their

  symptoms as early as possible."

   Kiley said the NHLBI will continue to lead in public education and

  outreach, primarily through the COPD Learn More Breathe Better campaign.

  COPD Learn More Breathe Better, the first national awareness campaign on

  COPD, aims to improve knowledge among those with and at risk for the

  disease, as well as health care providers - particularly those in a primary

  care setting. Now in 50 states and the District of Columbia, the Breathe

  Better Network of state and local organizations will be conducting

  activities and events throughout November as part of National COPD Awareness

  Month. The COPD Learn More Breathe Better campaign also has developed tools

  to facilitate discussions between providers and patients in the exam room.

   As part of the NHLBI's broader effort to bolster the federal dialogue on

  COPD, the institute also recently hosted a workshop attended by

  representatives from 22 federal agencies and institutes invested in COPD

  research and education, to discuss ways to enhance the federal response to

  this serious public health problem. The attendees shared information about

  current COPD activities and identified areas where collaboration could

  improve disease prevention, ascertainment, diagnosis, and treatment. The

  representatives next aim to meet with external, non-federal stakeholders to

  discuss ways to respond to the growing COPD burden.

  COPD most often occurs in people age 40 and older with a history of

  smoking. However, as many as 1 in 6 people with COPD have never smoked. COPD

  also can occur in people with a genetic condition known as alpha-1

  antitrypsin deficiency or through long-term exposure to substances that can

  irritate the lungs, such as dust or fumes.

   COPD is diagnosed with a simple test called spirometry, which can be

  conducted in a doctor's office. The test involves breathing out as hard and

  fast as possible into a tube connected to a machine that measures lung

  function.

   The NHLBI analyzed the results of the annual HealthStyles survey of public

  health attitudes, knowledge, practices, and lifestyle habits among a

  nationally-representative sample of U.S. adults, conducted each year by

  Porter Novelli, the communications contractor for the NHLBI's COPD Learn

  More Breathe Better campaign. The latest survey was conducted in summer

  2013; results represent a sample of 4,703 U.S. adults, and have a margin of

  error of 1.4 percentage points.

   Part of the National Institutes of Health, the National Heart, Lung, and

  Blood Institute (NHLBI) plans, conducts, and supports research related to

  the causes, prevention, diagnosis, and treatment of heart, blood vessel,

  lung, and blood diseases; and sleep disorders.  The Institute also

  administers national health education campaigns on women and heart disease,

  healthy weight for children, and other topics.

  <http://www.nhlbi.nih.gov>.

[smorgy8513]

Thomas, thank you.    I have my physical on Monday and have been thinking I need to talk to dr about doing test to rule out COPD.    I'm still having some wheezing and it has been 103 days since I quit.     Your blogs this month have been thuds on my head to do this.      I know I will feel better once it can be ruled out.

Sharon

[ret]

I THINK THAT FOR ME I DIDN'T WANT TO FACE THE FACT THAT CIGARETTES WERE CAUSING MY PROBLEM BECAUSE THEN I WOULD HAVE TO FACE THE FACT THAT I NEEDED TO QUIT.  I EVEN HID MY SYMTOMS FROM MY FAMILY. WHAT A POWERFULL ADDICTION SMOKING IS.  YET IT CAN BE CONQUERED AND ALL THO NOT EASY NOT AS HARD AS ONE MIGHT THINK.