COPD Foundation Releases Groundbreaking COPE Survey Results: Low Patient Awareness About COPD Exacerbations Poses Barrier to Effective Management

June 17, 2014

Findings highlight communication gap between patients and physicians

WASHINGTON, D.C. – June 17, 2014 – Patients with chronic obstructive pulmonary disease (COPD) may need more education and better dialogue with their physicians to effectively manage the progressive respiratory condition and potentially life-threatening complications known as exacerbations (or flare-ups), according to key findings from the new, two-part national COPE (Chronic Obstructive Pulmonary Experience) Survey initiative released today by the COPD Foundation.

While COPD exacerbations are a leading cause of hospitalization in the United States, nearly two-thirds (62 percent) of COPD patients surveyed admitted to not knowing much about them – and an additional 16 percent did not know what an exacerbation was at all. Sixty percent (60 percent) of COPD patients reported that they did not have an action plan for dealing with a flare-up. By contrast, in the part of the COPE Survey targeting physicians who treat COPD, almost all of them said they discuss exacerbations (98 percent) and establish action plans (92 percent) with their patients. This suggests an opportunity to improve care through more productive, meaningful communication between COPD patients and their physicians.

COPD is a serious lung disease that affects an estimated 24 million Americans and which over time makes it more difficult to breathe, partially because symptoms of the disease – such as shortness of breath, chronic coughing or wheezing, and production of excess mucus – come on slowly and continue to worsen. Exacerbations are acute periods when symptoms suddenly get worse, and breathing becomes even more difficult. Once a patient has an exacerbation – which can be mild, moderate, or severe – they are more likely to experience another one. In fact, COPD patients in the survey who experienced at least one exacerbation have suffered through an average of 22 exacerbations in their lifetime.

“Exacerbations can have a devastating impact on overall health, and they can actually cause COPD to progress even faster and reduce lung function,” says Scott Cerreta, director of Education, COPD Foundation. “Developing an action plan with instructions to help patients – and their caregivers – identify warning signs and what steps to take if an exacerbation should occur is a critical part of managing COPD.”

Early detection and proper diagnosis of COPD are also critical to managing the disease and slowing its progression, yet surveyed COPD patients indicated that they experienced symptoms of the disease for an average of two years and nine months prior to being diagnosed. Furthermore, surveyed physicians reported that 39 percent of their patients had reached a “severe” or “very severe” disease state by the time of diagnosis – results which indicate there may be an opportunity for earlier detection and intervention. Despite the importance of proper diagnosis of COPD severity, less than half (49 percent) of physicians surveyed reported that they always perform spirometry – a diagnostic tool that measures lung function – to confirm a diagnosis.

Additionally, the survey revealed that only 12 percent of COPD patients consider their condition to be “completely controlled” and indicated that COPD disrupts patients’ ability to complete normal daily activities such as exercising (87 percent), climbing stairs (86 percent), and walking (77 percent). Yet surprisingly, 82 percent of patients who have a COPD treatment regimen said they are satisfied with it, suggesting that many may be unaware that more could be done.

“COPD can be treated – but it’s crucial for doctors to diagnose it early and for patients to follow the appropriate therapeutic strategies to improve symptoms, increase activity, and reduce the chances of exacerbations,” said MeiLan Han, M.D., M.S., associate professor of Medicine in the Division of Pulmonary and Critical Care at the University of Michigan. “It's important that physicians develop an individualized approach that works best for each patient.”

The COPE patient and physician surveys were conducted by The COPD Foundation with support from Forest Laboratories, Inc., as part of Forest’s MORE Matters education campaign. The initiative aims to provide people living with COPD and their caregivers what they want MORE of: education about the condition, helpful resources, and the support needed to help them manage the disease. Additional information can be found at

About the COPD Patient Survey

The COPD patient survey was conducted online by Kelton Global between December 18, 2013 and January 8, 2014 among 1,102 Americans ages 40 and over who suffer from COPD, including chronic bronchitis or emphysema. Results of any sample are subject to sampling variation. The magnitude of the variation is measurable and is affected by the number of interviews and the level of the percentages expressing the results. In this particular study, the margin of error for the total sample is +/- three percent at the 95 percent confidence interval. The margin of error for any subgroups will be slightly higher.

About the Physician Survey

An online survey was conducted by M3 Global Research, a global healthcare market research firm. Internet survey interviews among a sample of 100 US pulmonologists and 100 primary care physicians were conducted between December 2013 and January 2014. Quotas were set by specialty and volume of COPD patients seen.

About COPD

COPD is a common, progressive, and debilitating lung disease characterized by persistent airflow limitation that makes it hard to breathe. The World Health Organization (WHO) has described COPD as a global epidemic; an estimated 64 million people have COPD worldwide. More than three million people died of the condition in 2005, which is equal to five percent of all deaths globally that year. Total deaths from COPD are projected to increase by more than 30 in the next 10 years without interventions to cut risks, particularly exposure to tobacco smoke. WHO predicts that COPD will become the third leading cause of death worldwide by 2030. COPD is already the third leading cause of death in the U.S.

In patients with COPD the airways in the lungs typically lose their elasticity, produce excess mucus and become thick and inflamed, limiting the passage of air. The most common symptoms of COPD are breathlessness (or a "need for air"), abnormal sputum (a mix of saliva and mucus in the airway), and chronic cough. As the condition worsens and breathlessness increases, daily activities, such as walking up a short flight of stairs or carrying a suitcase, can become very difficult.

About the COPD Foundation

Celebrating its 10th Anniversary and a decade of progress, the mission of the COPD Foundation ( is to prevent and cure chronic obstructive pulmonary disease and to improve the lives of all people affected by COPD. The C.O.P.D. Information Line, 866-316-COPD (2673), is a toll-free number for information and referrals on COPD, offering callers access to peer-to-peer patients and caregiver associates.

About Forest Laboratories and Its Products

Forest Laboratories (NYSE:FRX) is a leading, fully integrated, specialty pharmaceutical company largely focused on the United States market. Forest markets a portfolio of branded drug products and develops new medicines to treat patients suffering from diseases principally in five therapeutic areas: central nervous system, cardiovascular, gastrointestinal, respiratory, and anti-infective. Forest’s strategy of acquiring product rights for development and commercialization through licensing, collaborative partnerships and targeted mergers and acquisitions allows Forest to take advantage of attractive late-stage development and commercial opportunities, thereby managing the risks inherent in drug development. In January 2014, Forest acquired Aptalis Pharmaceuticals for $2.9 billion in cash in order to gain access to its GI and Cystic Fibrosis products, including treatments for Ulcerative Proctitis, Duodenal Ulcers, H. Pylori, Anal Fissures, and Pancreatic Insufficiency. In February 2014, Forest and Actavis plc announced an agreement where Forest would be acquired for about $25 billion in cash and stock. The acquisition of Forest by Actavis is contingent upon regulatory and shareholder approvals.

Forest is headquartered in New York, NY.