Respiratory experts have highlighted the shortfall in treatment for chronic obstructive pulmonary disease (COPD), compared with other big killers.
Speaking earlier this month at Clinical Consensus in COPD, held in London, UK, the experts demonstrated how the approach to the diagnosis of COPD patients, management of their acute exacerbations, and palliative care falls short of services provided for patients with heart disease or cancer.
Bart Celli, Professor of Medicine at Tufts University in Boston, Massachusetts, USA, said that patients hospitalized with a diagnosis of COPD are less likely to undergo confirmatory tests than those hospitalized with a diagnosis of congestive heart failure (CHF).
He referred to previous research showing that pulmonary function tests were used in just 31% of COPD patients, whereas 2-dimensional echocardiography was used in 78% of CHF patients.
“Our mission is to preach this test [spirometry] and continually hammer it,” he said.
Jean Barbeau, Director of the COPD and Pulmonary Rehabilitation Unit in Montreal, Canada, compared a COPD exacerbation to a myocardial infarction (MI).
She pointed out that, after an acute exacerbation, patients experience a faster decline in FEV1, worse symptoms, poorer health-related quality of life, and a higher risk of death associated with an exacerbation.
“We should recognize that an acute exacerbation is to COPD what an MI is to coronary artery disease,” she said.
She added: “The aim to treat only the acute episodes is not sufficient!”
Lisa Davies, Consultant Physician and Honorary Lecturer at University Hospital Aintree in the UK spoke about acute care for COPD in the community, and said that the definition of palliative care applies to all patients with COPD.
“That is what we should be offering to every patient.”
Describing an 84-year-old woman who needed a chair lift installed, she said: “If they had found a small cancer, she’d probably get the services she needs.”
She added: “I think cancer patients do need it, but I think our patients deserve it as well.”
Meeting website
